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Telemedicine and Asthma

By: Naomi Zilkha, MD (Telemedicine, Allied Physicians Group)

Hi Allied!

It’s time for #TelemedicineTuesday! Last week, I saw an Allied after-hours Telemedicine record number of patients, and almost all of them had asthma.

That’s because, last week (and so far, this week), it’s been really bad asthma weather. I am an asthmatic myself, with significant symptoms this time of year, so I was not surprised about the asthmatic patients I was seeing in my telemedicine office.

I’m glad for more patients –especially asthmatic patients—using Allied after-hours Telemedicine. To illustrate how awesome Allied telemedicine is vs. other telemedicine your insurance company might be trying to get you to use, I am going to tell you the tale of 2 asthmatics:

Patient number 1: (not my patient—was described on a FB telemedicine group by the doctor who saw this patient and was seeking advice):

13-year-old female known asthmatic uses large telemedicine company referred to her mom by their insurance company. Although this company does both video and phone consults, this one was from the phone only. The doc couldn’t see the patient and did not have her medical records.

Patient number 2 (a composite of all the patients I have seen in the past week for asthma, so I can really compare the different Telemedicine):

13-year-old female known asthmatic used after-hours Allied Telemedicine and sees me via video consultation. I have access to her entire medical record, and while mom was completing Phreesia, I was reviewing her chart, with attention to her asthma history.

Patient number 1:

Complaint causing the visit: cough. Mom told Telemedicine doc that her daughter was having “trouble breathing” and “just needed an inhaler called in”. Since the doc wasn’t able to see or even talk to the patient on the phone, she told the mom that “trouble breathing” means that she needs to go to the ER. Mom became irate and said that she wasn’t actually having that much trouble, and she knows her child, and all she needs is an inhaler. The doc refused to prescribe her an inhaler, the mom hung up on her, and then the doc came to the FB group looking for advice. The doctor has no follow up on the patient.

Patient number 2:

Complaint causing the visit: cough. Mom told me that she’s been having a worsening cough, which is typical of this time of year, especially with the weather we were having. Although I was not able to directly listen to the patient’s chest (I could have, had they had a Tyto device, but I don’t think it would have changed what I did during the visit). But what I could do, is see the patient for the whole visit and talk to her. Although she did have an “asthma cough”, she was talking comfortably in full sentences, and I was able to look at her chest and count her respiratory rate (just a little above normal) and check for any retractions (signs of additional trouble breathing—she had none). She had used her inhaler 4 hours before for the first time this season and wanted to know if she should start the nebulizer, or if she needed to go to urgent care. I was completely comfortable telling the mom that she should start her on the nebulizer and start her allergy meds that she normally starts this time of year. No need for Urgent Care. Mom and her daughter both were very happy with the plan, and the next morning, she was seen at walk-in hours, where my note about the visit was there waiting for the office manager and all the docs as soon as they logged into the computer for the day. After she was seen, I received an email to tell me that she was doing well this morning and that mom and daughter were both so happy with their first telemedicine visit.

And there you have it:

Patient number 1: very poor medical care

Patient number 2: high-quality telemedicine care, able to keep the patient from an unnecessary urgent care visit, and able to keep her in her Allied medical home.

Allied Telemedicine for the Win!!

Although I hope your kids aren’t suffering from asthma like I am, if they are having breathing issues after hours, please give Allied Telemedicine a try. I know you will be happy you did.

Remember, for after-hours care, #ThinkTelemedicine

-Dr. Z

Download it before you need it! To learn more about the Allied Telehealth program and how to download TytoCare, click here.