Telemedicine Suit

[George K]

https://www.washingtonpost.com/technology/2024/12/18/amazon-one-medical-lawsuit-wrongful-death/

One week before Christmas 2023, Philip Tong logged onto a video consultation with health-care clinic Amazon One Medical and said that he was short of breath, coughing up blood, and that his feet were turning blue. The provider told him to buy an inhaler, according to an October lawsuit.

Hours later, Tong collapsed in an emergency room in Oakland, California, according to a complaint filed against the hospital and One Medical. He died the same day.

The loss of Tong, who had diabetes and had been sick with flu-like symptoms for about a week before his death, was an abrupt blow to his wife Suzanne, a lawyer, and their two daughters.

Video appointments with medical professionals became much more common since the coronavirus pandemic. More than a fifth of adults reported attending a telehealth appointment between 2021 and 2022, according to a U.S. Department of Health and Human Services report, and experts say telehealth improves patient access to health care.
But the Tong family’s suit highlights questions about whether telemedicine is effective in life-threatening situations, especially those that patients themselves might have difficulty recognizing.
Simon Rowland, a researcher with health-care company Haleon who has studied telehealth and malpractice, said that while technology can help patients access health care, few providers receive special training in making remote diagnoses, which can be especially difficult in acute cases.
“Training in that area is in its infancy,” Rowland told The Post. “It’s a clinical scenario that people need to understand better in terms of the risks and benefits.”

Mrs. George had a tele-med encounter in July. THat's when she was sick with the parainfluenza virus - coughing up a lung and generally miserable. She was seen by a PA or APN. As soon as she said, "difficulty breathing" she was instructed to call 911 and be taken to the ER.

[Mik]

I've had a couple telemed visits too, but I'd never do it if I were seriously ill. The tell here will be what was actually said. The clinician can only act on what they are given and what they inquire about. The good thing is there will be a video record.

[Jolly]

I think the best use of telemedicine, is for follow-up visits with specialists in Healthcare settings. To practice effective medicine, I believe you have to be able to touch and talk to patients.

A telemedicine visit in a doctor's office, clinic or rural hospital has the advantage of medical personnel being able to physically interact with a patient before their visit with the specialist. LSU Med has had this in place with rural hospitals for almost a decade. It works pretty well.

Another place where telemedicine can be effective is in a routine eye exam for eyeglasses. A good opthalmic tech can do an auto refraction, check pressures and take photos of the retinal. The optometrist can remotely do a manual refraction (it's neat technology) based off the auto, check the pressure and retina photos, and cut the eyeglasses scrip. If they see something that needs investigation, they can refer to an ophthalmologist.

[George K]

@Jolly said in Telemedicine Suit:

think the best use of telemedicine, is for follow-up visits with specialists in Healthcare settings.

Yes. I have something that requires monitoring. After my initial visit with the doc, we got on a routine schedule after I'd have bloodwork done. We would either talk on the phone or televisit to discuss results. No need for a drive downtown in that case.

I believe you have to be able to touch and talk to patients.

In the early days of my career, before capnography, pulse oximetry, and automated blood pressure machines, I would hold a mask on the patient's face, and my left little finger would be positioned along the jaw, where I could feel the lingual artery pulse. I also had a stethoscope on the chest, connected via IV tubing to an earpiece I kept in my left ear. There are subtle things that you hear and feel that no tech can replace - but the tech is getting a lot better.

routine eye exam for eyeglasses

The HELL you say! Got a link?

[Jolly]

Last one done was my granddaughter. The eye exam was done at an America's Best shop (I got the twofer special for her).

My wife is a retired opthalmic tech and she knows more about this than I do. GD was dilated, the tech checked the pressure, and took the photos of the retina and optic nerve, and did an auto refraction.

GD then had a zoom(?) meeting with an optometrist. The tech put the readings from the auto refraction into a foreopter and the optom had GD look through it, while he did the "better or worse" dance. IIRC, the foreopter had a wire running into it, because the optom was controlling lens selection remotely.

The optometrist reviewed the photos, signed off no noted problems and cut the script electronically.