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Journal Club

September 29, 2021

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Journal Club

Inpatient ID Telemedicine: Is Perfect the Enemy of the Good?

By Erica Kaufman West, MD

While we all hope for the day we can once again go maskless in a hospital, some great advances have been made in the field of telemedicine during the COVID-19 pandemic. Telemedicine can be a real-time audio-video interaction (synchronous) or a review of digital data only (asynchronous), such as an electronic medical record. A report in Clinical Infectious Diseases from authors at Yale University School of Medicine and New Haven Hospital evaluated how such inpatient infectious diseases (ID) telemedicine consults were received by both the ID consultant and the hospital provider.

Although both synchronous and asynchronous telemedicine approaches were used, the researchers’ survey did not distinguish between the two. They received survey responses from 130 hospital providers (mostly internal medicine) and 23 ID consultants. A majority of the hospital providers felt that the quality of the telemedicine consult was the same or better as a traditional consult (66.9%), the timeliness was the same or better (98.5%), and the communication between teams was the same or better (80%). Eighty percent of respondents felt that the ID consultant provided good clinical care via telemedicine.

The majority of ID consultants (73.9%) felt that the quality of the telemedicine consult was worse than a traditional consult, although most did feel that their e-consults were timelier (91.3%). Communication satisfaction was the same as that reported by the hospital providers. ID consultants with more than 10 years of experience were more likely to state that the quality was worse (25.8% vs 42.9%) and to disagree with the statement that e-consults provided good clinical care (4.5% vs 19.6%) compared to ID consultants who had been practicing for 10 years or less.

Voltaire could never have imagined the technology we have today: We can see a patient on a computer screen hundreds of miles away. It would serve us ID providers well to not avoid inpatient telemedicine just because we cannot be 100% present. For the patients and providers on the other end of that tablet or other device, especially in rural and underserved communities, any access to an ID specialist is likely to be welcomed.

(Canterino et al. Clin Infect Dis. Published online: May 28, 2021.)

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