Pub. 3 2019 Issue 2

care head-on, the breadth and spectrum of what we deal with can feel heavy and laden with insecurities. It is nice to get support from our specialist colleagues, and telemedi- cine can be a means to make this happen. I have used this resource frequently for urgent matters such as access to intensivists, stroke specialists, neonatologists, infectious disease, crisis workers, and more. The ability to connect with these teams virtually has taken a load off, and I physi- cally feel less tense at work. My team in the hospital has gained confidence in their skills and the abilities of our fa- cility to care for whatever surprises might walk in the door that day. Recently, an inpatient who was under my care became unstable and suffered from worsening altered mental status. The diagnosis was unclear to me, and it was evident that it was going to be a long night of interaction with the nurses and the patient. I had a remote intensivist do a telemedicine consult, and this service essentially took care of the patient for me all night. I was able to get some sleep knowing that the patient would be getting excellent care. A full night’s rest made a busy day in the clinic the next day so much easier! From a rural perspective, I feel less alone on the island than ever. As the scope of practice generally narrows in family medicine, this type of digital support could help physicians keep confident about infre- quently used skills. Digital support is a telemedicine win for physicians that can truly be transformative for fellow primary care providers. Lastly, health care has become too expensive, and we must find ways to make it more affordable for our patients while maintaining safety and quality. Telemedicine has the potential to help with this as well. As we accept more financial risk for patients, we need to work with teams and be able to communicate in different ways from the traditional face-to-face visits. We must connect by sending messages electronically, perhaps doing video consults, and even relying on other team members to connect digitally to do work that has typically fallen on physicians, particu- larly administrative tasks. Family physicians are masters of innovation and should be thought leaders in how technol- ogy can improve workflows and ultimately decrease overall financial burden to patients and the system. The stars seemed to have aligned for telemedicine, and the wave is coming. Technology is improving, financial incen- tives are changing, and insurances are more open to this type of service. Health care is looking for innovative ways to improve consumerism, physician well-being and lower cost of care. Technology giants such as Apple, Google, and Amazon are investing their vast resources into health care and will certainly be looking to better digital engagement between patients and providers. As stewards of American health, we cannot ignore these forces. Nothing will replace the physician-patient relationships that enticed us to become family physicians. Connection will continue to be the most powerful catalyst for meaningful health changes. How we connect with patients is evolving, and as technology improves, we need to embrace and add digital connectivity to our list of skills. Telemedicine can be smart growth for our communities and clinics, and as a proud generalist, I say, “Bring it on!” Dr. Jesse Spencer is a proud family physician. He serves as associate medical director in Rural Family Medicine and in Telehealth Services with Intermountain Healthcare. Patients win by improving access, physicians win by feeling increased support, and the system wins with potential healthcare savings. 37 |