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Medical Video Conferencing. Implications for Autism Diagnosis?
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Medical video conferencing is becoming a powerful tool for bringing expertise to the patient rather than the reverse. Numerous projects are under way for its implementation. It appears that this is a technology with potential for providing much needed expertise in evaluating children who exhibit symptoms of autism.
In order to begin early intervention, for any medical diagnosis, an early and accurate diagnosis is required. In August a 58-year old man went to a small hospital with symptoms that were quickly confirmed to be a stroke. The accurate diagnosis of a stroke, as well as determining the onset of symptoms, are important before deciding on the plan of care including the administration of medication.
When a person needs to be assessed by a specialist, whether to obtain a diagnosis or for ongoing treatment, medical video-conferencing is making a positive impact in many places. Medical specialists are able to observe a patient via a video camera, there is also two-way video conferencing so that the patient can see the specialist. Think of it as being similar to instant messaging with a web cam, only better. Some people may think that this approach is lacking the personal touch of a primary care physician or lacking the hands on approach that is required for accurate assessment, yet in many ways it actually improves assessment and diagnosis which then improves treatment and outcomes. The 58 year-old man and his wife can testify to that.
The personal hands on assessment is still present as a medical professional, a doctor or a nurse, remain with the patient while the specialist is observing via the video camera. The specialist is able to ask questions of the patient in order to hear as well as see the responses and the medical professional in the room can help administer the exam, for example testing reflexes.
This method of care is gaining support from doctors, health care administrators, The American Heart Association, patients, and their families. The state of Colorado plans to connect over 400 of their health facilities with video-conferencing. University of Pittsburgh Medical Center has links to 26 smaller facilities. University of Texas Medical Branch at Galverston has over 350 which also includes some out of the country.
Even though the case of a stroke victim is the most clear argument for medical video-conferencing the impact it has for newborns will also weigh in on the human aspect to health insurance companies that may choose to refuse to pay for this service now.
Some hospitals have admitted they use this technology and service even though insurance companies may not reimburse the hospital or the doctor. They do it because “it would not be ethical to delay care”. Emergency and crisis situations, like the stroke victim mentioned, require timely actions.
The cases of newborn care may help decrease the cost directly to the insurance companies if they just look at the cost for medical transport versus a video-conference. When a baby is born with any question of potential high risk medical needs rural hospitals know they may not be equipped to diagnose and treat some conditions. If they are aware, or concerned of a problem before birth they will often transport the laboring mother. If they are not aware of a problem until after the birth then they will need to transport the baby shortly after birth, separating the mother and infant in the crucial first hours and days of bonding for life. The need to transfer a high risk newborn to a hospital with specialists available is a standard that may be avoided if the hospital has in place this telemedicine approach.
