Dr. Alan Pitt is a physician and professor of neuroradiology at Barrow Neurological Institute located in Phoenix, Arizona. Dr. Pitt recently completed an interview with EMS World at the 2016 American Telemedicine Association (ATA). You can find a few highlights from the ATA interview below.
EMS World: Does EMS have a role in facilitating telemedicine?
Alan Pitt, MD: For sure. EMS can act as an extender, can reach into the home, can provide an additional level of care. I also think that EMS has an opportunity to engage, for instance, stroke patients. We’re seeing an increasing uptick in when care begins for that stroke patient. It used to be scoop and go, now people are looking to put EMS with CT out into the field. So I think this idea of supporting people with the right resources, that you can reach the right place, is absolutely critical and an opportunity. The sooner we can have EMS there with that support, the sooner we can begin the right treatment for many of these people.
And on the flipside again, I was really stunned to hear about the pilot in MESA where EMS is reaching into the home to follow some of these real high utilizers. So they’re leveraging their skills, often down time, to really take care of these frequent utilizers, and reduce their cost of care. I think that’s a great use of community resources that allow EMS to really be present. It’s a win for everybody.
EMS World: Do you still need mobile stroke units if you’ve got the neurologist on your tablet? The goal of the CT scan is obviously to diagnose, but can some of that be done virtually and save the time of the CT scan to speed patient care?
Alan Pitt, MD: I think it’s the package that really makes the big difference, so think about the state we are in today. I have a patient with stroke. EMS arrives. They don’t have a neurologist except by phone, maybe, they don’t have a CT scan. You certainly can’t administer tPA or other clot-busting agents without documenting that there’s not a hemorrhage bite. I’m a neuroradiologist by training so I look at all the imaging that surrounds stroke. I think the idea of being able to offer EMS backed up by neurology, along with imaging, would cut critical time on stroke care. The next question would be, “Could I do EMS without the neurologist?” I don’t think so, because even if you look at rural facilities with emergency room physicians, that’s a tough call really, to decide to administer drugs that could hurt. I think you need a whole constellation of things that come together around that patient at the earliest possible moment to make a difference.
EMS World: So do you need telemedicine in the mobile stroke unit?
Alan Pitt, MD: Yes. Because I’m a big believer in the blink, right? As a physician you may tell me something over the phone, but I’d really like to lay my eyes on what’s going on, and frankly I think it’s not only of value for me as a physician to see the patient, but it’s also of value for the patient to see me, and have their family see me, and know that care is starting with the best possible person. They can have confidence in who’s delivering their care. I think there’s a huge value-add around that as well. I think that’s really the value that you jump from when you go to video instead of telephony.
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