March 20, 2016

ENT House Visits? ENT Telemedicine?

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The year 2016 may be the tipping point where telemedicine and doctors making house calls may become a mainstream phenomenon. Certainly, in the areas of primary and urgent care, such services have been around for several years. More recently, specialty care in the fields of neurology, rheumatology, infectious diseases, etc have especially pervaded  small community hospitals where such services may be absent.

Some doctor house visit services include Heal in Los Angeles, Pager in New York City, and Mend in Dallas.

Telemedicine services are located nationally hosted by private companies as well as many tertiary care centers.

However, telemedicine and house calls have yet to make significant ingress in the surgical fields which include ENT.

When it comes to ENT, much of what we do is very similar to what a primary care doctor can already do... look in the ears, nose, and throat. However, what differentiates ENT from primary care are the procedural interventions that can be performed to try and figure out what may be ailing a patient not responding to the usual treatment. Indeed, the majority of patients seen in the ENT clinic undergo some type of procedural evaluation or treatment beyond what a primary care doctor is able to do.

Very common ENT procedures include:

1) Endoscopy - performed to evaluate hoarse voice, nasal obstruction, oral masses, etc.
2) Binocular ear microscopy - used to evaluate ear foreign bodies, eardrum perforations, earwax removal, etc.
3) Audiograms - test performed to evaluate pretty much any type of ear symptom including tinnitus, hearing loss, ear clogging, etc.
4) Scheduling and performing surgical procedures

Indeed, a home visit may require a van full of equipment to support what an ENT may need to do, as well as to clean/sterilize the equipment after being used. 

The very need for equipment and procedural interventions are factors that also inhibit telemedicine from being adopted by the ENT world. 

That said, I am sure there are very smart people who are trying to figure out how to allow technology to overcome these limitations. At this time, the only thing that may be reasonably possible is a 2nd opinion chart review.  Cleveland Clinic and Johns Hopkins offers such chart review ENT services.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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