Guest Post - Jaron Ross, MD

Every now and then on Progress Notes we like to share the thoughts of important voices in the virtual care world. Today's post comes from Jaron Ross, MD, an emergency medicine physician in California. 

Maybe Telemedicine Can Empower Patients and Doctors Alike.

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Most physicians, like myself, have at some point in life christened their career in medicine as a means to “change the world.” We all intend incredibly well, seeking honorable careers that help others while also generally providing well for our own families. But in the harsh byzantine reality of modern health care these dreams often die young. We resign ourselves to the rare bright spots: the dramatic cardiac arrest save, an exotic diagnosis, the reassured parent. And—though this could just be me—the follow-up phone call. The final chance to make things right. One last opportunity to close the loop, ensure the patient is doing well, pain controlled, plan in place, expectations met (theirs and mine). Because we honestly want nothing more than to do the right thing.

I’ve watched from afar as friends in tech and admin have joined startups planning to “do well by doing good.” But little seems to have happened. It seems the arrival of revolutionary connecting technologies has long been heralded but never delivered. Maybe instead of revolutionary, it need only be evolutionary.

Dr. Blake McKinney and I trained together and have long shared a mutual interest in policy, tech, and the complex ideal of social welfare in medicine. I was skeptical, but curious, years ago when he founded CirrusMD, but in following their progress have been duly impressed with their path to widening the front door to patient access. More striking to me though—and the reason I’m writing now—is the potential for patient surveillance, re-entrainment, and follow-up. The back door. Not to mention streamlined consultations, prescriptions, work notes, social arrangements, data mining, targeted treatment, and public health. It’s the side doors, the curbside door, all the doors—via simple text!

As any ER doc can attest, the 2 AM call about your niece’s fever or neighbor’s head injury is not on video or FaceTime. It’s a call or text, followed by more texts and maybe a photo. Let’s face it, video is a bit intrusive, a bit uncontrolled, and a bit too real-time. Ironically, (where’s Malcolm Gladwell on this?) less sophisticated text messaging, with the requisite slight delay to communicate per life’s extrinsic time demands, has prevailed as the medium of choice. And choice matters.

Patients must actively choose to participate in their care. Health organizations should choose to implement systems that fully encompass care. Lately, several socially pro-active emergency medical groups have chosen to fill the follow-up void by engaging services like CirrusMD to ensure the right thing for the patient at the right time. Every time.

Ours is a capitalist society, and cost always seems a barrier to entry, but the farsighted recognize tremendously greater future savings in utilization, compliance, liability, and the unrivaled value of a healthy life. These conscientious EM groups are taking responsibility, their share and more, to be the doctors they always hoped to be. Changing the world one patient, and one text, at a time. May we all follow their lead…

Dr. Jaron Ross is a board-certified emergency physician with a long-standing interest in healthcare delivery and emergency department efficiency. He works in Northern California.