Hey everybody.
My name is Steve.
I am a social media specialist
at Rush University Medical Center
and we're going to be doing another Instagram live today.
We're going to be waiting a couple of moments,
to let everyone join while we get started.
Dr. Shah joins.
Okay and we're going to invite Dr. Shah to join us
in today's Instagram live.
Welcome everyone thanks for joining.
Hey Dr. Shah, how's it going?
Good how are you?
Good afternoon. Doing well.
Thanks so much for being here.
I'm going to give everyone just a quick second to join,
get ourselves situated.
We've got to nearly 30 people joining.
So I think we're going to get started.
So again, welcome everyone.
My name is Steve Mizek
I'm a social media specialist
at Rush University Medical Center.
And today we're going to to be talking with Dr. Meeta Shah
an emergency medicine physician
and associate chief medical informatics officer
at Rush University.
She is also one of Rush's On Demand providers.
And again, we want to thank her for joining us.
So to get started, tell us a little bit
about yourself and about your roles at Rush.
Sure.
I'm an emergency medicine physician by training.
So I'm board certified in emergency medicine.
I also am one of, kind of our tech geeks at the hospital,
so I work a lot with them, health information technology
and most recently a lot in telehealth.
So those are kind of my, my specialties here.
I am also an educator for the medical school.
Awesome.
And you've been a champion of the Rush On-Demand program
and Virtual Care since its inception.
I imagine that's part of you being a tech geek,
but what drew you to it
and why do you think it's such an important program?
I know, I think that the reality is as you know
particularly in my field of emergency medicine,
we see how access to care is so important.
And sometimes it's difficult
for patients to be able to get the care
that they need at the timeliness that they needed.
And, you know, there are all sorts of barriers
whether it's, you know time, childcare, transportation.
And I just think telehealth is kind of that way to
kind of have this virtual space where people can come
to their doctor's appointments and do it
in a convenient way so that they aren't delaying care.
And I think it's important.
Well, so the COVID-19 pandemic was obviously a big part
of how we got to virtual care where it is now,
it increased virtual care and video visits
and there's odd cause many people to advocate
for telehealth support, even after the pandemic.
What would you say is some of the biggest takeaways
from this last year of booming virtual care use has been?
So I think it's interesting
that in the world of technology, you know
that this is one thing we've been behind on
as telehealth is really kind of the case use has been there
for years.
There have been some barriers, whether it's, you know
like the legal barriers or
versus just kind of acceptance of this technology
or how do you get patients to understand how to use it.
And so, I mean, the pandemic sort of threw us
into that world and that was actually kind of
in some ways good for telehealth.
I mean, the pandemic has been terrible, but
in the way of telehealth has kind of proven its case.
I think there are several states that have
done telehealth well and others that have not
but now we're kind of all
on the same playing field, which has been great.
And again, I think it just proves
that we were able to do so much virtually
that we didn't realize we could do, right.
So I think, you know,
we live in these concepts are conceptually,
we think we have to do all of these things in person.
And we really got to prove the case that, you know
there are certain things that we can do virtually
and still have connection with our patients
be able to provide care when it's needed.
And then at the same time use, you know, what we know
which is what we can, we do virtually
what can we not do virtually
and make sure that we understand those two cases.
And when it's time to refer somebody to in-person care,
we still do that.
Right, of course.
One of the hurdles to adoption of the On Demand program
seems to be that
people aren't always certain what they should use it for
versus say,
going to a urgent care or an emergency department.
Can you take us through a few examples that illustrate how
those appointments can be best used in your experience?
Sure.
You know, I think that if you think about it this way
if you have a phone and you have less smartphone
with video device, that's first of all
a great way to kind of just at least try it out.
Secondly, you know, I think sort of intuitively you know
that we can't necessarily look in an ear via telehealth
but there's a lot we can do.
So, you know, if I want to check your pulse
I can get your help checking your pulse
I can get your respiratory rate.
I can have a patient help me say,
you know this is where I'm having pain
and show me on their abdomen or their arm or their leg.
And, you know, even things like rashes
things that are sort of external.
There's a lot of external things
that we can do virtually yes
I can't get a stethoscope to your chest or to your lungs
but there's so many things that we can address just
by external kind of questioning
both questioning and examination.
And if you think
that it's one of those cases, it's worth a try.
Right.
So maybe what's something that maybe
someone has come to you for virtual care
or I could tell a health visit, but you were like
actually this is not the best use of this.
This is something that you need to go
to the emergency department or see us in person.
Sure, I think one of the most common ones is chest pain.
You know, I think chest, particularly if you're
of a certain age, you know, you're over 40 or 50, you know
and you're describing chest pain,
I'm not sure that is something that didn't necessarily
rely virtual or particularly
if there's chest pain and shortness of breath.
You know, if you're reporting some shortness of breath
I'd love to listen to your lungs.
And so that might be something that we would want to do
in person.
Right, I understand that some virtual care appointments
have also been life-saving for some people.
Have you had some experiences with that yourself?
Yeah, and I think that's really, that's a great thing.
So, you know, sometimes we've had patients who are
on route from one place to another and you know
having some strange symptoms
and that's another great use for our platform.
So, we've had a couple
of cases where patients have actually called for chest pain
and the provider on has been able to give them
guidance that has literally saved their lives.
And so, you know, because they just weren't sure
if it was anything that they needed to take seriously
they had a lot of questions
about the symptoms that they were facing.
And we've had both scenarios where we've said,
Oh, actually yes.
There's something that I can take care of here
versus the others has been like, you know,
I don't feel comfortable with what you're saying.
I'd like you to go to an emergency department
either ours or the closest one to you.
And that has been sort of lifesaving for those patients.
You know, I, myself has seen patients where I've said
you know, I'm not comfortable with what you're saying.
That doesn't sound like heartburn.
That could be a chest pain equivalent.
We had a case recently where there was a patient
who wanted to come to Rush
because of his symptoms called our On-Demand platform.
And the person who was able to care
for him was really uncomfortable
with what the patient was saying and said
you really need to go to your closest emergency department.
And I think if he hadn't had that encounter with her
he may have like made the longer drive to Rush.
And in the end, him going
to the closer emergency department actually saved his life.
So, you know
I think even when you're not sure using platforms
like Telehealth to at least talk
to somebody who is a medical professional
and can give you guidance can be really
valuable when you're not sure of what to do next.
Absolutely, I understand that also these
that one of these visits also
you can put information that allow you to sort of
work together with our emergency departments.
So then you kind of know that someone's coming
or what they've already reported.
So they have sort of a basis from where to go from
from when they actually see a patient.
Yeah, for us to specially, you know
when we're working within the Rush system
when we kind of have an encounter that is concerning to us
we have a pathway for us to, you know, notify our colleagues
in the emergency departments say, you know, I, you know
On Demand visit, I'm really what this patient is saying.
And I think
that they need to be seen in the emergency department.
So at least when the patient arrives there
they already have some information to go off of,
and as a jumping point for their care.
What are some of the perhaps unexpected benefits
of using video visits that maybe people wouldn't think
of when they're, you know
even just listening to this right now?
Honestly, I think it's the time savings, you know
I think there's so many people out there that just
delay care because they don't have the time,
we're all working on negative time.
I feel like these days, and I still remember
there was one gentleman who I had seen who started laughing
at the end of this visit.
And he's like, this is so amazing.
It was so convenient.
I'm on my lunch break at work.
And I don't even know when I would've been able to go
in to see my doctor.
And he had pulled his back, moving some furniture
and he was just so happy that he was able to
see somebody kind of in his timeframe when he needed it.
And we were able to help him with his care,
and I think that's really been one of the most
beneficial parts of all of this.
I mean, in the, in the period of COVID of course, you know
we were able to safely see patients without, you know
risking any sorts of exposures, get them tested.
And so there were just a lot of benefits that we've seen
over the last year that I highly
advocate we keep, even after this pandemic is over
Yeah, that's a great dovetail actually
into my next question,
which is, you know, as the pandemic does begin
to wane and we can anticipate returning
to a more normal way of life
what can we do to make sure that we don't go backwards
in terms of using technology to supplement our healthcare?
I totally am on board with that question.
We really need to be advocating that this stays, you know
there's just, again, there's a lot that we can do.
We can make healthcare less expensive
if we continue down the path of Telehealth.
So you're talking to your legislators, talking
to your congressman, your governors, whoever your senators
and making sure that they know
that this is really, really helpful for healthcare.
And I think it's, that's kind of the way to go.
And then also just talking
to your doctors and saying, I really liked this.
I like being able to talk
to you this way and telling your friends about it.
I think too, those are all the important ways
that we can continue to advocate for it's use.
For sure and I agree that, I think that,
spreading the word is the best way.
'Cause I think that a lot
of people would benefit from this what you know
that maybe don't even know about it yet.
Right.
So just sort of wrap things up.
I wondered if you had some
common questions that people ask you
about virtual care that maybe could help convince
other people watching to give this a try.
Yeah, I think of a couple things.
Number one is, you know, I mean
tech issues are always frustrating and I get that and
you know, again, we dove into this really quickly.
And so everybody's sort of working on, you know
the super speed nature which telehealth rolled out.
And so some of the most common things is like, I, you know
I'm glitchy, I can't hear anything.
And so one of the things we always kind of
tell our patients is try to turn your phone on and off
or just shut down the app and turn it back on.
And oftentimes that fixes the issue kind of
another funny one that I think we've noticed a few times
is sometimes even just touching your screen to
turn the audio back on, gets it back on.
And so those are some little tech tricks.
I think when you're having difficulty with your visit
also being on wifi always helps as well.
A lot of these telehealth platforms work best on a phone.
Actually. I think a lot
of times we think that we want to use a laptop,
but actually works better with apps on a phone
or on an iPad.
So that's kind of another trick.
Another thing I think people come up
with is can I use telehealth for my kids?
I view health for my kids and I love it.
And so again, you know, if I think
that my kid is pulling on their ear
that might be something that might not be appropriate
but I've certainly had a couple of scenarios where
you know, I've been able to work with
my provider to get my childcare virtually
and it's been great.
That's great. I don't think that that a lot
of people realize that that's an option for parents
because I feel like
especially now when time is so pressed, you know
being able to have a telehealth appointment
I'm sure it saves a lot of time in childcare as well.
Yeah. And especially with, you know, I know this
schools are being very cautious and, you know
and it's very helpful to parents as well to have that
you know, expanded access to care for our parents.
And, you know
I think there are, of course, some, some limitations.
You know, really small babies.
I mean, we that's a little safer to do in person
but you know, my daughter was six when we did her visits
and it was great because she was able to communicate
with the provider on the other side as well.
That's awesome and you know, you got to love that
even a kid can interact with people.
They don't, they don't need much help.
This is, this is second nature to them already.
Correct. Yeah.
Awesome.
Well, we have to wrap it up, but thank you,
Dr. Shah so much for taking the time to chat
with us about virtual care and telehealth.
We really appreciate your advocacy for this program
and thanks for everyone for tuning in and participating
in sending us questions and adding quests comments
please make sure to visit rush.edu
for more information about COVID vaccinations,
telehealth we've got all that information there
and we'll keep it updated.
Again thanks Dr. Shah.
Thanks everyone.
And we'll see next time.
Bye bye.