“Video Dial-a-Doctor” (Telemedicine) Seen Easing Shortage in Rural U.S.

From Bloomberg:

As part of a state-wide initiative, the rural county has installed videoconferencing equipment at all 10 of its schools to give its 5,782 students one-on-one access to physicians. Telemedicine sites for adults have also sprung in the area. Instead of taking a full day off from work or school, residents can now regularly see their specialist online.

The program places Georgia among a half-dozen U.S. states turning to telemedicine to address a shortage of doctors in rural areas, a gap the Obama administration has said is a serious health-care shortcoming. At the same time, it is allowing companies such as medical provider Sentara Healthcare and MDLive, a remote technology developer, to get a toehold in a new and growing market.

How accurately can emergency department providers estimate patient satisfaction?

From the Western Journal of Emergency Medicine:


Patient satisfaction is an important measure of emergency department (ED) quality of care. Little is known about providers’ ability to estimate patient satisfaction. We aimed to measure providers’ ability to assess patient satisfaction and hypothesized that providers could accurately estimate overall patient satisfaction.


We surveyed ED patients regarding satisfaction with their care. Treating providers completed analogous surveys, estimating patients’ responses. Sexual assault victims and non-English-speaking or severely ill patients were excluded. Satisfaction responses were categorized as “satisfied” or “not satisfied.” Patient satisfaction scores were considered the “gold standard,” and providers’ perceptions of the patient satisfaction were considered tests. Measures of diagnostic accuracy, such as positive predictive value (PPV) and sensitivity, were used to assess how accurately the provider could estimate his or her patient’s satisfaction.


Here, 242/457 eligible patients (53%) completed the survey; 227 providers (94%) completed a corresponding survey. Subject-reported overall satisfaction was 96.6%, compared with a provider-estimated rate of 94.4%. The sensitivity and PPV of the provider’s estimate of the patient’s satisfaction were 95.2 (95% confidence interval [CI] 91.4, 97.7) and 97.5 (95% CI 94.4, 99.2), respectively, for overall patient satisfaction. The PPV was similar for clarity of communication. The PPV was 78.9 for perceived length of ED stay (99% CI 70.8, 85.6) and 82.6 for quality of pain control (95% CI 68.6, 92.3). Accuracy of attending and resident estimates of patient satisfaction did not differ significantly. The agreement between patient-reported and provider-estimated patient satisfaction was not associated with age, gender, patient disposition, or ED divert status.


Providers are able to assess overall patient satisfaction and clarity of communication with a high accuracy. Physician estimates of pain control and perceived length of stay have a moderate accuracy.

MedicAlert’s PrEMISE Program Gives Providers Access to Patient ID and Information

From MedicAlert:

Through this new online service you will be able to access our member’s vital medical and identification information. In addition, this service is also backed up by our proven live 24/7 emergency response services toll-free line.

Patient information at your fingertips:

  • Medical conditions
  • Medications and dosages
  • Allergies
  • Emergency contacts
  • Physician information
  • Implanted devices
  • Clinical trial information
  • Advance directives, and much more…

This service is intended for use by licensed healthcare professionals such as emergency physicians, nurses as well as EMT and paramedics. Please register with us to join our community of healthcare professionals

New Prehospital Cardiac Arrest Resuscitation Paradigm n Oklahoma

From JEMS:

In the August 2012 issue of JEMS, we introduced a comprehensive restructuring of the EMS System for Metropolitan Oklahoma City and Tulsa’s cardiac arrest program using a three-part approach: chest compression fundamentals, resuscitation team dynamics and accelerated feedback on resuscitation performance. We discussed the benefit of going “back to the basics” of chest compression fundamentals training, increasing our rate to 120 chest compressions per minute and using metronomes to attain and maintain that rate throughout resuscitations. Now, we share how those fundamentals were incorporated into a Resuscitation Team Playbook and how we use directed feedback to further refine resuscitation performance.