Anyone can talk to a doctor without leaving their home thanks to telemedicine


Over one summer weekend – maybe it was late July, maybe early August, he doesn’t exactly remember – Andrew Galligan, a resident of Warren, started to feel pretty tired and weak. He passed out on the couch that Saturday afternoon and his wife, Kim, couldn’t wake him.

On Sunday, he developed a fever. He had also had to deal with gas. He was going to wait until Monday to go to the doctor, but Kim, who works at Brown University, told her husband about a new service that Brown Emergency Medicine had recently been launched whereby people could call an emergency doctor on a laptop or mobile phone for a video tour.

So, despite his urge to go to sleep, he decided to give it a try. Or as Kim, who is an unpaid board member for Brown Emergency Medicine, laughs, “I pushed the computer in front of his face. He was unwilling.

The face that appeared on the other side of his computer screen was not that of an intern or medical student, not a wet beginner behind his ears.

“Holy cow,” Andrew thought, “I know this lady.”

“I knew his face from TV,” said Galligan, who still has an Irish accent from his hometown of Dublin. “She was right there, looking at me.”

“It was an absolute delight,” said emergency doctor on the other end of the laptop, Megan Ranney, in an interview.

Ranney is best known nationally these days for her appearance on TV screens: She has become a go-to voice for CNN and other media to discuss COVID.

But she’s still a practicing emergency physician as ever, and Galligan was her first telemedicine patient.

“I felt really lucky to be able to take care of him,” Ranney said. “I’m really glad he called instead of just suffering.”

So what the hell was Galligan ill?Ranney, Galligan said, asked Kim to prick her stomach a bit.

Sharp pain. Appendicitis. He would need to be operated.

Ranney looked for a hospital he could go to. The Miriam was not too busy. She told Miriam he was on his way.

At 1 a.m., just hours after his telemedicine visit, Galligan, 54, was under the knife, his appendix, which may not have remained intact until Monday, was surgically removed.

“I think it was fantastic,” said Galligan of his telehealth background. “Say I just had gas and you go to the hospital and you spend six hours in a waiting room, and you are told you have gas – that’s a way of getting over it. feel silly.

“I think a lot of guys like me, you really must be dead before you go to the doctor, you know what I mean?”

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So far, the virtual patient queue has been a

Yes, and above all during the COVID pandemic,this reluctance has become even more acute.

That’s where Brown Emergency Medicine’s new telehealth service comes in. From anywhere in the state with an internet connection and a smartphone, tablet, or laptop, people can get care for urgent – but not life-threatening – issues through video chat.

Telemedicine has been developing for years. And thanks to COVID, it will likely only increase. One of Governor Gina Raimondo’s first decrees regarding the virus in March was to expand access to telemedicine and ensure reimbursement.

The initiative of Brown Emergency Medicine, a group of independent doctors, began in July. Now that COVID is resurfacing, stretching hospitals and emergency departments, its practitioners are presenting it as an option to take care of acute medical needs.

So far, the virtual patient queue has been a “steady stream,” say those who run it, and they would be happier if they were busier.

“Word has to get out,” said Dr. Susan Duffy, a pediatric emergency physician who co-leads the Brown Emergency Medicine program.

The group of doctors work at Lifespan Hospitals, which include the only Level 1 trauma center in the area, at the Rhode Island Hospital. But Lifespan itself is not involved in this telemedicine initiative.

The Brown Emergency Medicine telehealth program seeks to fill a niche in Rhode Island – acute, but not fatal, medical needs. Although the platform is staffed with emergency doctors, if you have a real emergency, such as a gunshot or chest pain, call 911 or go to the emergency room.

But if you think you might have COVID or the flu, or have a sports injury and aren’t sure if they need stitches, or your child has a worrying rash, sore throat, falls minor or a sprain? This is when it might be easier to do telemedicine. The website is https://www.brownemtelecare.org. It is available from noon to midnight, seven days a week.

Of course, there are national players in the telemedicine game. So what’s the value proposition of doing this with the folks from the local physician group?

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“We’re practicing at a higher level than you would get in an emergency care department,” Duffy said. “And we are local experts. We manage the emergency services of this state. We know the health care providers.

There are of course limits to telemedicine. Doctors cannot get a hold of a patient over the phone. Not everyone has a pulse oximeter or blood pressure monitor at home. There is also the question of access. Not everyone has an internet connection, let alone a smartphone or laptop with a camera.

“We’re going to have to be really careful to make sure people can access it,” Duffy said in a telephone interview.

“We're practicing at a higher level than you would get in an emergency department,” says Dr. Susan Duffy.  “And we are local experts.  We manage the emergency services of this state.  We know the health care providers.

Taking into account a journalism lesson on reporting on soup kitchens – you have to try the soup – The Providence Journal made a mock visit with this telemedicine initiative. The patient, 32, was negative for COVID but reported a recent asthma flare.

You have to fill out a few forms – they buy insurance – and then you will receive an SMS saying, if your name is Brian, “Brian: The doctor at Brown EM Telecare is ready to see you. “

In all, it took about 10 minutes from filling out an online form to seeing the doctor.

Program co-director Dr Gary Bubly, from his book-filled office in Somerset, appeared on the other end of the camera phone. He quickly determined that the patient looked fine right now – was not using any accessory muscles to breathe.

He asked the patient to take his own pulse, count the heartbeats, and that was fine too – 68 beats per minute. The patient walked around for a bit, then showed a few of his inhalers while discussing asthma.

“Patients love it,” Bubly said in an interview with Telehealth Platform, a Zoom-ish provider called Healow who is fully HIPAA compliant. “Every patient likes it. ”

Bubly likes it too. It’s a different atmosphere in her home office than in a busy emergency department.

And one of the benefits of telemedicine is actually the COVID protection itself: While in the hospital, Bubly wears an N95 mask, which can become uncomfortable after a few hours. At 60, he’s worried about exposure, but with telehealth, a patient can put the phone’s camera directly into his mouth to check for abscesses without any issues for either.

Meanwhile, just as he might in person, Bubly can prescribe medication, order tests, or, if things go bad enough, tell the patient to go to the hospital.

“The genie came out of the bottle with telemedicine,” Bubly said. “It’s so convenient.”

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