Telehealth for the Hospitalist: What’s Next?

By Ameet Doshi, MD, MBA |  February 21, 2020 | 

“Where are you?” is the first question that comes out of my patient’s mouth. Not the typical query, but then, this isn’t a ‘typical’ patient encounter. It’s actually a valid concern, considering I’m about 60 miles and two snow-strewn highways from the hospital room my patient is currently in, admitted for a COPD exacerbation. Yet, with two screens and the finest fiber-optic connection the Twin Cities can provide, healthcare is available at the press of a button. And it’s in this moment that I think, not for the first time, of the strange yet mutually beneficial relationship that telehealth has created between my patient and me.

I have been managing the ever-growing hospitalist telemedicine program for my organization for two years and change, and there isn’t a week when someone exclaims about how novel the telehealth experience is. Yet, telehealth is also one of the fastest growing fields in healthcare; while only 35% of hospitals reported using telehealth in 2010, 76% of hospitals did so in 2017. Further, patients continue to report high satisfaction with their virtual care experiences.

At HM19, we presented on telehealth scenarios that can help increase access to care for rural patients, distribute resources more efficiently, and reduce provider burnout. However, even with the current advancements in telehealth, there is always the future to be thinking about. At HM20 in San Diego, we intend to convey this future by discussing the newest innovations in telehealth using both broad visualizations and specific case examples. In doing so, we aim to furnish every attendee with the information on how telehealth can help their patients, their organizations, and their health care providers. Mark your calendar now for Saturday, April 18 at 9:50 a.m. for a deep dive into the future of telehealth. (Haven’t registered? Learn more about HM20 and register here.)

One specific scenario we plan to explore is tele-dermatology as a key example of how hospitals are increasing the scope of telehealth applications. In such situations where live video encounters may not be practical, the use of store-and-forward technology can allow specialists to review still images and provide diagnosis and management. This means that whether their dermatologist is three miles or three thousand miles away, patients can get the care they need, including for life-threatening conditions.

Another area in which telehealth is transforming hospital medicine revolves around the transformation of hospital medicine itself. Instead of being billed as hospitalists, with the parochial emphasis on location, there is a sea trend towards focusing on the acute care mandate of our profession and its obvious corollary, post-acute care management. Hospital-at-home, community paramedics, patient engagement centers – these are but some of the avenues in which patient care is advancing, and avenues in which telehealth can provide the optimal route.

The last high-level takeaway I hope to impart to attendees is that in whatever scenario telehealth is used, it is always essential to place the patient, and the human connection, first. Seeing a provider over a screen may not (and should not, most would say) replace the bedside provider, but it can bridge the gaps where that traditional patient experience is not present.

My patient, who wondered where I was at the onset, spent a couple days at the hospital receiving care from my excellent nursing and physician colleagues. She made a comment to her nurse as she was being discharged: “I’m so glad I came here.” And as telehealth continues to advance, I hope that this becomes the prevailing sentiment – not about the novelty, but about how it was able to provide patients the care they deserve.

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About the Author: Ameet Doshi, MD, MBA

Dr. Ameet Doshi is a lead hospitalist for telemedicine for HealthPartners. After originally completing a combined BA/MD program with The College of New Jersey and the University of Medicine and Dentistry of New Jersey – New Jersey Medical School, he completed an internal medicine residency at Abbott Northwestern Hospital in Minneapolis, MN. He joined the HealthPartners organization in 2016 as a hospitalist, and in December 2017, he was named the telemedicine lead physician for the hospital medicine department. In addition, he completed a MBA from Oregon State University in 2018, with a focused track in executive leadership. Dr. Doshi currently works on all facets of telemedicine and in trying to expand its utility in delivering care to patients in underserved areas, improving physician-nurse communication, and reducing provider burnout.

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