Emergency Department Patient Assessments by Medical Students via Video
Clinical medical students, unable to conduct in-person emergency department (ED) patient assessments, were given the opportunity to conduct these assessments remotely. Each student had access to the ED computer system via VPN on their personal computer and a hospital approved, HIPAA compliant video communication on their personal smartphone. In the ED, a tablet computer was securely connected to a wheeled monitor stand that the student could securely connect to via their phone. A resident or faculty member would assess the patient, determine that they were stable for the video interview and consented to it. The student can then review the triage note, vitals and relevant old records via their personal computer and the tablet computer would then be placed in the patient room and the student would conduct the interview. The student is able to see and hear the patient live and vice versa. Once the interview is complete, the faculty physician enters and completes a physical exam which can be observed by the student. The student calls the ED faculty physician using the same HIPAA compliant system and presents a modified patient presentation to the faculty with differential diagnoses and a diagnostic and therapeutic management plan. The student then follows up on diagnostic study results and nurse reassessments via computer, looks up relevant information using resources at their disposal and calls back to the ED to speak to the physician to further discuss the case until disposition is reached. Although this cannot truly replace live ED patient encounters for students, our students found it of great value. An additional benefit is student exposure to the expanding role of telemedicine.