Those who are skeptical of telemedicine question whether the quality of care provided by a video visit can match that of an in-office visit, but a recent study suggests that clinical impressions are retained highly during telemedicine consultations.
The researchers examined whether bedside clinicians and remote providers formed the same conclusions when evaluating pediatric patients for signs of respiratory distress. The study consisted of two parts: examining 132 infants and toddlers brought to the emergency room with fever or respiratory distress, and evaluating 145 youths ages 2 months to 18 years with respiratory symptoms. Both scenarios resulted in agreement between bedside and remote observers.
In the emergency department, clinicians used the Yale Observation Scale. For the second portion, the authors of the study developed a Respiratory Observation Checklist, which includes visual signs of respiratory distress and mental status. The bedside and remote clinicians observed the patients simultaneously, and bedside evaluations were designated the gold standard.
In the emergency care situation, all observers agreed strongly across all scores. In the non-acute care setting, the clinicians agreed strongly on whether a patient was in respiratory distress. They showed good agreement for signs such as thoracoabdominal breathing and supraclavicular retractions and fair agreement for intercostal retractions.
The authors concluded that such consistent agreement regarding the presence of respiratory distress indicates that clinical impressions remain present with telemedicine. They will conduct more studies exploring the reliability of telemedicine.
Although patients have generally been satisfied with the quality of care received through telemedicine, we welcome studies such as these—both to lend greater credibility to the voice of the patient, and to demonstrate that telemedicine is just another tool to help providers offer high-quality care.