Even when that call is finally made to summon the on-call doctor, "there's a lag time which could be 40 minutes. The doctor is in the gym or in the middle of dinner. They have to get themselves together. And there can be an hour's delay before the person arrives."
Having a physician on-call through telemedicine solves that problem. The exam can speed up the ordering of blood work or imaging, getting those processes started long before they otherwise would be.
Guss says the pilot project hasn't tried it yet, but theoretically, with a secure WIFI connection, a telemedicine exam of an ED patient "could be done if I were in my car with a laptop and a cell phone network. I could pull in to a parking lot and see a patient or two, and then move on.
"You can't do this at Starbucks though. You have to protect the patient's privacy," he says.
So far, Guss says, there have been no adverse events or unintended consequences. One patient with a suspected ear infection was treated and discharged from the ED to home came back with the same complaint and was admitted for one day. The patients are followed to make sure there are no issues related to their visit that resulted in them requiring treatment at UCSD or another hospital.
Often, patients come to the ED with routine requests, for example, a medication refill, for treatment of a sore throat, or even a sprained ankle.
We can evaluate them, make sure there are no other issues, check their medical history and then take the case to completion.