Point of View Telemedicine at Point of Care

Study Objectives: Increasingly in recent foreign conflicts and disaster zones, forward deployed healthcare providers strive to communicate with their physician and specialist extra-theater counterparts with the aim of providing improved patient care and outcomes. So far, these efforts have been limited to email consultation, with the exception of specialized teams with limited video capability. Several organizations have attempted to provide real-time video audio interaction in an attempt to extend the capabilities of modern medicine to rural settings and various natural disasters. So far these efforts have required expensive, large pieces of equipment and technological expertise. We aimed to show that ultra-portable live-streamed point of view video consultation had a significant impact on simulated patient outcomes and is feasible with current technology.

Methods: We utilized a double-blinded randomized crossover design. Each tester was evaluated on various patient outcomes to include: time to identification of life threats, time to critical interventions, triage categories, and time to evacuation decision.

Results: Results showed there was a significant decrease in the time to evacuation for patients with video feed (p=0.009) Otherwise the data showed no significant difference in the addition of video as opposed to sole two way radio in terms of the number of interventions, time to interventions, or operator or teleconsultant confidence in care or procedures performed. Subjects did not perform significantly more interventions in the second iteration indicating no training effect.

Conclusion: It is possible that given the teleconsultant was able to visualize the injuries and vitals, evacuation was impressed upon the operator as the priority, without sacrificing life-saving interventions. This study demonstrated the feasibility and ease of a highly portable (weight less than 3 lbs. in total) and economical (total cost <$500) rugged telemedicine platform with live video and two way radio capabilities.

Dr Wells Weymouth

Wells Weymouth is co-Chief Resident of the Emergency Medicine Residency at the San Antonio Military Medical Center located in San Antonio, Texas, the only Medical Command Level I trauma center in the United States and which serves over 80,000 patients in the emergency department annually. Also a Captain in the United States Army, he attended the military’s medical school located in Washington D.C. Awards include Chief ’s Award, City of Gaithersburg Fire and Rescue, Air Assault, Airborne, Antarctic Service Award, and the Fulbright Scholarship to New Zealand. He is a graduate of the University of Florida, and originally from the St. Petersburg  area.