It was an honor to sit on the panel for a presentation on ‘Telemedicine: practical tips for implementation into your daily practice’ at this past years’ Academy of Otolaryngology Head and Neck Surgery Annual Meeting. Since it was in New Orleans, I wasn’t that upset about traveling to the city of Jazz and beignets.
I was honestly surprised and impressed by how well the talk was attended, and it was great to see so many other otolaryngologists looking to incorporate telemedicine into their practice to improve patient care.
The other members of the panel were inspiring: Dr. John Kokesh helped create a system of telehealth to provide otolaryngology care to the underserved across the vast distances of Alaska, and Dr. David Cognetti has been utilizing telehealth in an urban settings in innovative ways to improve the quality of Jefferson University Health’s Head and Neck Cancer Care. If you have an interest in telemedicine in ENT, you should read about these two innovators work.
The full video of the panel can be found on the AAO-HNS website, under the AcademyU (however you must be an Academy member to view it).
We hope to expand upon the panel next year. Thank you to everyone who attended.
My latest piece, telemedicine in Otolaryngology, written with one of the key opinion leaders in the field, Dr. John Kokesh, was just published in the Bulletin of the Academy of Otolaryngology. Ultimately, I believe that as adoption of telemedicine increases, it will be one of the many techniques we will use to bring down costs of specialty care in our healthcare system.
You can view it below, or at the Academy’s website:
Read the Article here
You may find the original article here at the publisher’s website.
We will be exhibiting the initial results of our tele-medical BPPV consult study as a poster for the Triological Society session at the Combined Otolaryngology Spring Meetings for 2017.Discussion posted below for ease of reading:
Within our small sample size, a number of patients who were referred for an evaluation of their dizziness had initially undergone a CT or MRI in the emergency department to evaluate their complaint of dizziness.
Our initial proof of concept study found that for a small sample size, remote diagnosis of BPPV via telemedical consults is possible with high specificity. Based on the specificity, it is appears unlikely that a trained otologist or neurologist reviewing videos of ocular findings of a DHT would misdiagnose a more concerning cause of dizziness as BPPV. Thus, this could easily serve as a screening tool to quickly triage dizzy patients into those requiring more costly work-up and those who do not.
While other authors have suggested using video-oculography  or educational algorithms  to help distinguish benign versus concerning causes of dizziness, the barriers to adoption of these methods are the cost of equipment and ER workflow. However, due to the prevalence of HIPAA-compliant texting applications and the ubiquity of smartphones, adoption of smartphone-based video consults into an ER workflow is feasible. This is supported by a recent survey of worldwide ER physicians, which found that many wanted assistance with evaluating and distinguishing causes of dizziness . While academic centers may have neurologists or otolarygologists on call, rural and community centers could gain access to these specialists through telemedical means.
Since the DHT is easily taught, having an otolaryngologist interpret the resulting eye movements remotely may increase usage of the test and may lead to cost savings.