What should you expect when you schedule a telehealth appointment with our physicians? John Carmichael, MD, and Sirisha Mohan, MD, walk you through the process and offer helpful tips on how to make the most of the experience.
Category Archives: Videos
DIABETES MANAGEMENT: “SMART INSULIN PUMPS”
Technology is finally innovating diabetes management. With the advancement in technologies like continuous glucose monitors, traditional insulin pumps are evolving into smarter devices that can automate insulin delivery.
Medtronic and Tandem Diabetes are the only two companies to offer hybrid closed loop systems. A community of diabetics are also hacking pumps to do the same thing. CNBC’s Erin Black just switched from the hacked system to Tandem’s Control-IQ and takes a look at how insulin pumps are getting smarter.
HEALTH: “MAKING SENSE OF CORONAVIRUS DATA” (VIDEO)
Public health organizations track the spread of coronavirus and use graphs and charts to visualize the data. WSJ’s Brianna Abbott explains what to look for in the data to understand how the virus is impacting your community.
Photo illustration: Laura Kammermann/WSJ
NEW TECHNOLOGY: SMART BANDAGES – “A HEALING REVOLUTION” (TUFTS VIDEO)
On the 100th anniversary of the Band-Aid, Tufts engineer Sameer Sonkusale is working to make “smart” bandages.
COMMENTARY
The Tuft’s video talks about transforming the Band-Aid into a detector that can warn of infection, or even exude the proper antibiotic. This would certainly be Applicable to Convalescent homes where people can’t monitor their own healing.
I am Looking forward to the time when the bandage will provide a matrix for the body’s regenerative cells to spread out and cover the wound more rapidly. Possibly someday the regenerative cells themselves can be applied.
—Dr. C.
TELEMENTAL HEALTHCARE: “BENEFITS OF MENTAL HEALTH TASK SHARING”
Lynsay Ayer, senior behavioral scientist with the RAND Corporation, describes how task sharing helps fill the need for more mental health care providers.
ORTHOPAEDICS: “TOTAL JOINT REPLACEMENT” (UCSF)
Hip and knee replacement are two of the most commonly performed operations in orthopedic surgery. UCSF orthopedic surgeon Dr. Paul Toogood takes a closer look at what Total Joint Replacement actually is, how it improves your quality of life, and what some of the considerations are when having this surgical procedure.
HEALTH: “UNDERSTANDING ARTHRITIS” – ORTHOPAEDIC TRAUMA INSTITUTE (VIDEO)
PROVIDERS: DARTMOUTH-HITCHCOCK CENTER FOR TELEHEALTH (VIDEO TOUR)
TeleHealth Services
Our Dartmouth-Hitchcock TeleHealth Service Lines include the following:
Outpatient Virtual Visits (formerly TeleSpecialty)
Outpatient Virtual Visits connect patients and health care providers to Dartmouth-Hitchcock specialists via scheduled outpatient TeleHealth visits. Outpatient Virtual Visits increase access to specialty care services for patients located in rural or underserved areas and improves the patient experience via more convenient access to specialty care with reduced travel. D-H Outpatient Virtual Visit services currently offered including specialty clinic appointments, direct-to-patient home visits and inpatient consultations.
TeleEmergency
TeleEmergencyprovides a board-certified emergency medicine physician and an experienced emergency nurse to join the bedside team, on-demand, 24/7. Using high-quality, two-way audio-video communication, the TeleEmergency team assists by whatever means requested, including nursing documentation, direct patient care, consultation, a second set of eyes, assistance with transfer coordination, acceptance, and/or transport.
TeleICN
TeleICN allows D-H Neonatologists to join your bedside team to serve the needs of you and your patients for a wide variety of diagnoses. Some babies require a higher level of care as they adjust to life outside of the mother’s body. The 24/7 support of ICN services helps keep patients and families closer to home by supporting clinical decision making and providing expert evaluations and recommendations. If a transfer is necessary, our specialized ICN team will assist in transporting that patient.
TeleICU
TeleICU provides experienced intensive care physicians and critical care nurses to augment, not replace, the bedside team. In addition, the service provides behind-the-scenes, high-level monitoring and sophisticated analytical algorithms to identifying concerning trends prior to patient deterioration. Not only does this result in decreased mortality and length of stay; it also allows more patients to get their ICU care close to home.
TeleNeurology
TeleNeurologyprovides board-certified neurologists on-demand 24/7 for Emergency Department and inpatient consultations. This includes not only stroke (including evaluation and recommendations, and assistance with tPA administration), but also assistance with other adult neurologic emergencies. This allows a lower cost coverage option for hospitals with limited or no neurologist access, improved tPA administration rates and decreased transfers.
TelePharmacy
TelePharmacyconnects hospitals to a team of dedicated pharmacists who can provide medication order review and processing as well as clinical consultation, allowing hospitals to optimize their internal staffing while remaining compliant with order review regulations. D-H TelePharmacy improves medication efficacy, patient safety and staff satisfaction while also supporting the integration of pharmacy delivery within hospital systems and/or regions, including protocols and order sets.
TelePsychiatry
TelePsychiatryenables prompt assessment and management of patients in the Emergency Department or inpatient setting for locations that do not have around-the-clock psychiatric coverage. Board-certified psychiatrists provide 24/7, on-demand assessments including expedited admit vs. discharge decisions, early management recommendations, and assistance with medication management, while improving the ultimate patient trajectory.
TeleUrgent Care
TeleUrgent Care provides back-up, support and consultation to Urgent Care providers by emergency medicine physicians via high-definition, two-way audio-video conferencing. TeleUrgent Care physician input can include general recommendations, real-time patient assessments, second opinions, advice regarding the need and timing of additional emergent or urgent evaluations, review of radiographic images, and assistance with volume surges.
MEN’S HEALTH: YOUR “FIRST PROSTATE CHECKUP” (UCLA)
Dr. Jesse Mills, Director of The Men’s Clinic at UCLA talks about what to expect during a first prostate checkup.
COMMENTARY
Prostate checking, especially by PSA, has been controversial in recent years.
The naysayers have cited statistics that show too many unnecessary operations on slow-growing, non-life threatening cancers lowering quality-of-life.
My old urologist was following a prostate nodule with yearly checks with PSA tests. He retired, and the enlightened, younger urologist, who replaced him, thought PSA superfluous.
A friend, also a Doctor, was similarly advised, dropped the PSA screening, developed high grade prostatic Cancer, and died of it.
I continued checking my PSA every 6 months, risking a positive test, leading to biopsy, leading to unnecessary treatment.
The UCLA prostate checkup video touts Prostate MRI as an intermediate step, and, in my mind validates my choice of continuing PSA screening.
—Dr. C
PREVENTION: “FORWARD CLINICS” ARE ALL-INCLUSIVE, FLAT-FEE PRIMARY CARE
Forward care is evidence-based, focused on prevention and improvement. Set goals and collaborate for better health.
- Connect Your Biometrics Sensors
- Receive your Sensor Kit
- Record measurements in the app
- Review insights together with your doctor
- Complete Your Labs at Home
- Schedule your at-home blood draw with a lab specialist
- Receive comprehensive results
- Create a Personalized Plan During Your Baseline Visit
- Discuss your health goals and concerns
- Review your biometrics and lab results
- Develop a personalized, preventive plan
- Answer Questions In-App for Insights on Your Mental Health
- Answer a short series of questions in-app
- Receive a measure for anxiety and depression
- Partner with your doctor on your results
- Customize Your Plan Based on Your Genetics
- Receive your Genetics Kit
- Review the results with your doctor
- Update your plan to address your risks
- See Your Doctor In Person for a Custom Follow Up Visit
- Request an in-person visit in the app
- Review your progress with your doctor
- Complete a physical exam and diagnostics
- Assess Your Skin Cancer Risk
- Complete a physical exam of your skin
- Capture high-definition images of any moles or blemishes
- Discuss your skin health and cancer risks with your doctor
- Receive a Message From Your Doctor to Update Your Plan
- Your doctor will check-in regularly
- Update your doctor on progress and goals
- Ask questions, anytime from anywhere
- Develop Nutrition Goals Based on Recurring Labs
- Review your latest labs with your doctor
- Develop a nutrition plan for targeted results
- Measure progress with future labs
COMMENTARY
Forward Healthcare differs from a conventional primary care clinic in several, generally good ways.
Most importantly, they stress PREVENTATIVE care. Blood tests that monitor diabetes, metabolic syndrome, and anemia are done regularly, since they have a laboratory on premises. They have their own EMR (electronic medical record) platform, and their own telemedicine platform, which are downloaded on the initial visit.
They give out a “sensor kit” consisting of temperature monitor, Pulse-oximetry, and a BP monitor, which wirelessly sends information to medical records.
Telemedicine is available through their own Downloaded platform. Although I get the impression that Telehealth isn’t as central as I would have expected in a technology oriented operation, it is increasingly important.
The monthly membership fee of $149 pays for the above and unlimited Doctor Availability 24/7 without copay.
Concierge Medicine has the monthly/yearly fee and unlimited access, but has a copay. Both will utilize your insurance, and neither treats patients in the hospital or provides referral care.
Government Health care is coming, and with it longer waiting times, shorter Doctor interaction times, and probably less time for Preventative Health Care.
Systems like Forward Health and Concierge Medicine will be the upper tier of a 2-tier system.
Proactive attention to Health in my opinion is essential in the future if we are to have a healthy nation, and not “bankrupt the system”. Telehealth is growing in importance, and offers help in making medical expertise more convenient, widely available and for less cost.
I am happy to see progressive Systems like Forward Health offer a preventative option to the present, broken, reverse-incentivized, fee-for-service System.
Doctors Without Waiting Rooms 