Physicians Office News Briefs
75 counties are designated as medically
underserved. A program for Arkansas' family
physicians, obstetricians, neonatologists, and
pediatricians has expanded its telemedicine
program and has increased patient access to
specialty care. Increasing use of telemedicine
has been shown to reduce emergency
department visits among schoolchildren;
telemedicine could handle 85 percent of
pediatric primary care office visits and 40
percent of emergency department visits.
Furthermore, telemedicine allows patients to
self-manage their conditions; for example,
allowing veterans to live independently at
home.
"Telemedicine is not different medicine,"
Jason Mitchell, M.D., director of the AAFP's
Center for Health IT, said in a statement. "It's a
different interaction."
T
eledermatology Is
Reliable for Initial Triage
Consultations
Teledermatology is reliable for
initial triage of patients, according to a study
published online Feb. 12 in JAMA Dermatology.
John S. Barbieri, from the University of
Pennsylvania in Philadelphia, and colleagues
conducted a prospective study among 50
consenting adult patients, hospitalized for any
indication, for whom an inpatient dermatology
consultation was requested between Sept. 1,
2012, and April 31, 2013. An in-person
dermatologist and two independent
teledermatologists evaluated participants.
The researchers found that the
teledermatologist agreed with the in-person
dermatologist in 90 percent of consultations
in which the in-person dermatologist
recommended the patient be seen the same
day, and in 95 percent of cases in which the
in-person dermatologist recommended
biopsy. There was substantial diagnostic
agreement between the teledermatologist
and the in-person dermatologist, even when
the teledermatologist did not choose the
same course of action. Teledermatologists
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were able to triage 60 and 10 percent of
consultations to be seen the next day or later
or as outpatients after discharge, respectively.
"Our study suggests that teledermatology
is reliable for the initial triage of inpatient
dermatologic consultations at an academic
medical center and that it can potentially
increase efficiency," the authors conclude. "We
anticipate that future studies that refine the
model presented here may find stronger
concordance and efficiency gains."
One author disclosed financial ties to the
telemedicine industry.
M
ysterious Polio-Like
Illness Strikes Children
in California
A rare "polio-like syndrome"
has caused paralysis in about 20 children from
across California, according to a report
released Sunday by physicians in the San
Francisco Bay Area.
The children, who are between the ages of 3
and 12, developed acute, flaccid paralysis.
These cases suggest there is a possibility of a
new infectious polio-like syndrome in
California, Keith Van Haren, M.D., author of the
case report and a pediatric neurologist at
Lucile Packard Children's Hospital at Stanford
University told HealthDay. The children who
have been affected seem to have been
permanently paralyzed, he said. The illness is
not polio; all the victims had been immunized
against polio and tested negative for the
presence of the disease, Van Haren explained.
And the disease is rare. "It's not an epidemic,"
he said. "But it is something that is concerning."
Van Haren said some victims suddenly
developed weakness of one or more limbs
within about 48 hours of becoming sick.
Magnetic resonance imaging scans showed
worrisome changes in the gray matter of the
spinal cord. To help them more effectively fight
the disease, the children were given steroids,
intravenous immunoglobulin and/or blood
plasma exchange -- without improvement,
according to the authors of the case report.
Parents who notice a sudden onset of