Teleconsultation in a Synchronous Fashion

Previously I discussed telehealth and telemedicine. One additional category is teleconsultation. This refers primary physician-to-physician or other provider interactions in a synchronous fashion.  Teleconsultation serves to reduce maldistribution of medical expertise, reduces transportation barriers to this expertise and reduces financial barriers.

One major part of teleconsultation is teleradiology (http://pubs.rsna.org/doi/full/10.1148/radiol.2433070350 ). Basically, this is the remote reading of radiologic images by radiologists who is no located where the images where taken. The fact that much of medical imaging has become digital and is stored in secure cloud so that it can be accessed from anywhere. Teleradiology has the advantage of obtaining readings on CT scans, MRIs and cardiac imaging from specialists at remote centers.

Teleconsultation also includes provider-to-provider video calls to discuss complex patients. This can be for diagnostic purposes or treatment recommendations. Teleconsultation may also incorporate provider-to-provider education. This could be around a new infectious disease, new procedures or other medical issues best communicated through live video.

Finally, teleconsultation can enable patient care team consultation even if the team is not located in one place. The application can include EMR information on patients as well as video chat capabilities and secure messaging between remotely based team members, such as, in rural clinics. 

A future application is called telerobotic surgery (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356984/ ). Robotic surgery is becoming common in many medical centers with the surgery using the robotics within the operating room. Telerobotic surgery is surgery done remotely with the robotic controls being used by the surgeon in one location and the surgery being performed with these robotic tools on the patient in another location. Some have suggested the need for this in future space exploration.

Teleconsultation has a growing number of applications as more care becomes virtualized and real-time interactions between providers scale internationally.

About the Contributor
John Sharp, MSSA, PMP, FHIMSS, is Senior Manager, Personal Connected Health Alliance for HIMSS North America