Assistive Devices Helpful
This was reflected in the Mayo study, which noted that the most challenging assessment was looking at a patient's pupillary reaction in response to light. The bedside nurses had difficulty keeping the eyelid elevated enough for the neurologist viewing it on screen.
But Demaerschalk also says that technology is constantly advancing, and even specialties that require some form of physical exam can plug assistive devices, such as a stethoscope, into the robot at the bedside.
Researchers pointed to a potential solution to the pupillary reaction problem: Devices called pupilometers, which objectively measure the diameter of a pupil in ambient light and that can be a peripheral attachment to the robotic telemedicine unit.
Demaerschalk believes that telemedicine has a role in every discipline, "If one is imaginative and looks to the future." It's up to researchers to tailor the way telemedicine is used based on where they find it works best and where it's less effective.
"Nothing is off the table," he says. "It's our job to ask these questions."
Collaboration is Key
Mayo Clinic is asking those questions in the context of its Center for Connected Care, where Demaerschalk is medical director.
The objective of the Center "is to ensure that when patients present to a community hospital with an emergency that they have available to them the same or similar expertise as if they were presenting to one of the main Mayo Clinic campuses," he says.
For hospital administrators, Demaerschalk notes that successful development of telemedicine programs still "rests quite soundly on the relationships that are developed and maintained between the two hospitals or health systems that are working collaboratively."
Alexandra Wilson Pecci is an editor for HealthLeaders.