Telemedicine as an Innovative Clinical Advancement

Christine Bishundat  
Med Ed Committee

     As the prevalence of chronic disease among Americans continues to rise, the need for access to primary care doctors and preventative medicine is becoming increasingly more important. There are many difficulties surrounding the delivery of primary care, particularly to rural areas. To improve communication between medical teams across wide geographic areas, a new conferencing method called “telemedicine” has been developed in the past several years. Patients have seen positive effects of this new communication technique. In fact, some care providers are actively incorporating (1) telemedicine into routine medical practice. Physicians in New Mexico can now easily reach patients in rural areas, bringing education and service to under-served areas.
     Project ECHO has been adopted by BIDMC to serve its geriatric patients. It gives a new meaning to the idea of the "house call." Physicians, nurses, and patients primarily in under-served communities work in dynamic multidisciplinary teams to improve primary care delivery. The goal is for patients to get quality consultations in a timely manner. Ideally, Project ECHO will also help to transform the paradigm of interprofessional teamwork. Physicians, nurses, and other specialists have virtual huddles to discuss cases in grand rounds, participate in shared decision-making, and provide each other with feedback (2). This method also promotes patient-centered medical care in a practical setting. With further development of this initiative, healthcare costs could improve and medical visits will become more efficient for some patients.

1. Domrzalski, Dennis. "Martinez Wants More Money for Telemedicine." American City Business Journals, 2 Dec. 2013. Web. 27 Jan. 2014.

2. Zigmond, Jessica. "Project ECHO Expands, Spreads Telehealth Model." Healthcare Business News, Research and Events from Modern Healthcare. Modern Healthcare, 26 June 2013. Web. 27 Jan. 2014.

New to Didactics: An Innovative Interprofessional Curriculum

The CCC-BIDMC crew has been working hard over the last year to embody "interprofessionalism." When medical students work alongside nurse practitioner students, pharmacy students, and other healthcare professionals, they learn to value teamwork early in their professional careers. They say raising a child takes a village, and taking care of patients definitely takes a TEAM.

In this evening's didactic session, Dr. Amy Weinstein and senior director Megan Koster introduced a new interprofessional education (IPE) curriculum called Team Stepps to CCC-BIDMC.  In a series of four lectures, they hope to teach students how to work on a team of healthcare workers from different professional backgrounds. 

The first lecture focused on leadership, which they defined as "a process of motivating people to work together collaboratively to accomplish tasks." There are four main characteristics to effective leadership:

1. Role Modeling
2. Shaping teamwork through open sharing of information
3. Constructive and timely feedback
4. Facilitation of briefs, huddles, debriefs, and conflict resolution

What Team Stepps calls "briefs" are the same as our pre-clinic huddles, so we have that one covered. The use of mid-session "huddles" is something that we haven't fully incorporated in our clinic practice at CCC."Debriefs" or post-clinic feedback is something we've been talking about a lot on the medical education committee. We're hoping to pilot a new 360 degree feedback method for SC/JC teams.

 
Students shared several learning "pearls" at the end of the session, including the importance of agenda setting and communication flow. It was great to see the room rearranged into four tables to facilitate group discussion between our medical, NP, and pharmacy students.

Energy was high tonight, so we are all looking forward to our next IPE Teamwork session on "Situation Monitoring" on February 18th.

-Laura Cohen MSIV, Senior Director and Med Ed Committee Chair

Image of the Week 1/28/2014

 

A patient presents with the following physical findings.  What is seen here and what is the most likely cause?