Virtual Exams: The Right Rx for What Ails You?

SALT LAKE CITY, Utah — On a chilly, fall Friday morning in Rock Springs, Wyoming, four pediatric patients gather in an examination room at Memorial Hospital of Sweetwater County. Their orthopedic surgeon, Dr. Theresa Hennessey, is examining them more than 185 miles away at Shriners Hospital in Salt Lake City.

Welcome to telemedicine.

Virtual follow-up

“You can hook up monitoring systems. You can get tests. For general medicine, for general pediatric, things where you’re monitoring someone’s health, it’s fantastic,” said Hennessey, who is also an associate professor of orthopedics at the University of Utah.

The patients also think it’s fantastic – none of the appointments on this day lasted longer than 20 minutes.

“Instead of driving all the way down to Salt Lake and pay for a [hotel] room and gas and all of that, we’ve been very grateful to use telehealth,” said Stephanie Neece. Her son Aiden was accidentally run over by a lawn mower when he was four.

Bringing specialty care to rural hospitals

A short distance from Shriners, a similar scenario is playing out at the University Hospital.

Dr. Ted Kimball is a surgical intensivist who tends to critically ill patients at rural hospitals. He does it virtually through a robot he can control from his phone.

“I can drive our robot and look at that patient, talk to the patient, talk to the family, talk to the doctor right at the bedside,” he said. “There is just no way to have that type of specialist in every rural hospital.”

Telemedicine helps bring that specialized expertise to more people. A patient can stay at home or at a local hospital, rather than being flown to University Hospital.

University of Utah Health offers a variety of medical specialists to doctors and nurses at 35 rural hospitals across the Intermountain West. Those medical specialties include dermatology, cardiology, burn care, strokes, speech prenatal care, eye care and more.

Project ECHO

Kimball says the university also sets itself apart by offering what he calls a “whole virtual education curriculum.”

KSL attended one of those sessions as Dr. Terry Box, a nationally-renowned expert in liver transplants, led a discussion with a team of doctors on hepatitis C. Known as Project ECHO, hospitals train doctors in specialty care by offering lectures and case studies via video conferencing on a weekly or bi-monthly basis.

“We’ve leveled the playing field in a way relative to patient access,” said Box, who is an associate professor at the Department of Internal Medicine at the University of Utah.

Urgent care

Telemedicine is getting even more accessible for patients by offering physician visits on a phone or computer.

“The convenience part of that is a big deal,” said Adam Hornung, the director of telehealth at Intermountain Healthcare.

Essentially, it’s urgent care without the wait. The virtual exam is offered anywhere, anytime. And the cost could be considerably less than an in-person urgent care visit, depending on your insurance, according to a study conducted this year by Regence.

That’s why many healthcare companies are getting in on this growing industry.

Intermountain Healthcare has its virtual exam service known as Connect Care. University of Utah Health offers one known as Virtual Visits. And there are a host of other virtual services that can be found on the internet that have no connection to a brick-and-mortar hospital.

When to see a doctor in-person

But virtual urgent care services shouldn’t be used for all ailments. While it’s generally a great starting point for a fever, cold and flu symptoms, a respiratory infection, conjunctivitis, sinus infection, sore throat, a mild sprain or allergies, there are circumstances that always warrant an in-person visit with a medical professional.

“If you’re bleeding and in need of stitches, Connect Care is not going to be helpful for you,” Hornung warned.

And keep in mind, launching an urgent care visit on your phone or home computer could carry some risks.

According to research published in May 2016 of the Journal of the American Medical Association, 67 volunteers tested eight virtual care companies. Of those 599 visits, patients were given an incorrect diagnosis or no diagnosis at all 23.5% of the time. Many of the missed or missing diagnoses were for common ailments such as sore throats, sinus infections, low back pain, and urinary tract infections.

Bottom line, in a real emergency, you need a doctor. But for less serious maladies, we all want to save time, and that’s where telemedicine comes into play.

“I don’t think a lot of times patients associate convenience with health care,” said Hornung. “We’re looking to change that.”