Go virtual, both in the classroom and in the clinic

The COVID-19 pandemic has led to profound advances in our ability to utilize telemedicine services for patients in the form of routine visits, consultations, and even physical exams. With social distancing guidelines and medical facility closures to prevent disease transmission, countless patients have seen elective appointments and screenings cancelled.

Over time, telemedicine has been promoted as a stopgap solution to prevent patients from losing not only medical services, but also opportunities to communicate with their medical providers.

Despite being heavily propelled by the COVID-19 pandemic, telemedicine has been a slow growing industry over the past decade. During the pandemic, telehealth visits increased by 154%. In the first deadly months of the pandemic, nearly a third of doctor visits were over teleplatformsand 95% of health centers now report telehealth capabilities.

Using telehealth for regular office visits offers many benefits to patients and physicians. Namely, telehealth — and the sophisticated platforms that come with that technology — provide convenience, allowing patients to check in with their providers more frequently via video call or text message without having to go to the office.

Many such platforms, integrated with the accompanying electronic medical records, are currently used by larger health systems and are shared between satellite facilities, providing patients with the ability to view lab results and medical reports. imaging as well as communicate with their providers, improving engagement and enhancing the patient experience.

Additionally, telehealth helps patients with more complex and rarer diseases obtain high-quality care at tertiary medical centers, which may be located farther from home in larger cities.

Telehealth visits can also reduce long-term costs. Overall, reduced costs and no need to travel will improve access, especially for our most marginalized communities.

Other methods of incorporating telemedicine include forward triage and remote consultations, according to Robert Glatter, assistant professor of emergency medicine at Lenox Hill Hospital and editor of Medscape Emergency Medicine.

The emergency department (ED) can greatly benefit from early online visits before patients are transferred to the department for further care, and this model has been is gaining popularity. The ability to triage and categorize patients before an ER visit can reduce clutter and streamline care improving health outcomes while enhancing the patient experience.

This direct-to-consumer approach further reduces the risks of infectious exposure for healthcare workers, hospital staff, and low-risk patients who would have made an emergency room visit but for the advent of telemedicine services.

Because of the lasting nature of this change, it is important that we prepare the next generation of physicians to provide optimal care through this new platform. Clearly, the methods of conducting physical exams, interviewing patients, or even offering empathetic communication are profoundly different when done via video call.

Although much medical service will return to in-person visits post-pandemic, and some services inherently cannot be performed remotely, telemedicine is definitely here to stay. Therefore, physicians will need to develop the skills necessary to provide high quality care in this setting. In the unfortunate event of another future pandemic, our doctors will be better equipped to make a seamless transition to remote care.

Decades ago, medical schools only offered didactic science-based education in large lecture halls, aimed at providing students with a solid scientific foundation before they moved on to hospital floors for their rotations and internships. . Over time, medical education has incorporated an increasingly patient-centred curriculum, introducing small group sessions and case-based learning to enhance the soft skills and critical thinking abilities of future physicians.

The next era of medical education should continue to build on this trend.

Of course, a solid scientific basis is important. However, this not only indicates that it is ineffective to focus on the exclusive learning of basic sciences by medical students, but also that our future doctors must prioritize humanistic skills and emotional intelligence rather than to mere knowledge. Moreover, with the arrival of artificial intelligence and robotics, soft skills and humanism will only gain in importance. Therefore, it makes sense to leverage and embrace these priorities going forward.

With the emergence of telemedicine, clinical skills sessions should incorporate these additional skills. Adding patient case simulations where students learn to perform physical examination techniques remotely can help.

Likewise, teaching students how to communicate effectively on a video call platform can be important in increasing patient comfort while reducing discomfort or miscommunication. That said, the subtle nonverbal cues of facial expressions and eye movements are becoming more important in the realm of telemedicine. These nuanced skills are honed through practice alongside mentors and peers.

With large numbers of Americans living with chronic diseases, we will see more health devices and monitoring tools routinely generating data for physicians. It has already started with the Apple Watch and other similar devices, but will expand to include emerging technologies that enable seamless integration with electronic medical records and communication with large silos of data repositories.

Many experts foresee daily monitoring of key biological variables for patients, with emerging data silos being designed to monitor these variables while also having “patient care monitoring centers of excellence” to integrate, analyze and interpret data. changes in the biological health status of patients. Physicians would then be alerted when abnormal functioning patterns emerge and require assessment and management.

New artificial intelligence avatars are being developed and are being used to triage emergency department patients, perform anamnesis or initial consultations, or consult chronically ill patients on a daily basis to alert physicians live when problems arise. These technologies hold great promise for patient outcomes, efficiency, cost reduction, and disease prevention, but they are also of concern because they create the potential for a dehumanized form of medical care.

Clinical skills courses dealing with the integration of these technologies into clinical best practices will be helpful in preparing our future healthcare providers.

Discuss considerations such as telehealth etiquette, security, and privacy when reviewing health information online; how to improve personal connection and the patient experience during a remote meeting; and conducting procedures or diagnoses in a remote setting will better equip medical students for the future of medicine.

It is highly likely that the number of patient encounters conducted remotely will only continue to increase. Today’s medical schools must anticipate this trend to prepare our future physicians for a smooth transition, and so that they can help optimize the integration of these new technologies for the benefit of our patients.

Robert Glatter, assistant professor of emergency medicine at Lenox Hill Hospital and editor of Medscape Emergency Medicine, was an expert contributor to this article..

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About Yash B. Shah

Yash Shah is a first-year medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania. He earned a Bachelor of Science in Premedicine from Penn State University. Prior to attending medical school, Yash worked in clinical and translational research in hematology/oncology at Children’s Hospital of Philadelphia. Yash has a longstanding interest in advancing medical education, improving health care policy and economics, and working with cancer patients. In his spare time, he enjoys playing tennis, cheering on the Eagles, reading and traveling.

Norma A. Roth