We are talking a lot about social distancing….
….the one and a half meter distance we are supposed to keep between our fellow human beings. At least in our country, Netherlands. The Coronavirus is also the cause of the interpersonal separation in medicine. Where possible of course.
Stemoscope
An example, I am currently trying to focus on the possibilities for the wireless stethoscope (=stemoscope) as used in Wuhan, China. Really on the front line in the Intensive Care Unit (ICU). However remote care, telemedicine or eHealth, arose out of necessity. The physical distance could be conveyed somewhat with technique. It was the time when there was no Internet or the PC on the desk. Let alone the smartphone.
Green screen
Cathode Ray tube oscillography. Yes, that is where my involvement with remote care, telemedicine or ehealth actually started. The situation in the seventies of the last century is hard to be imagined nowadays. I took up the position of (the second) internist in a small regional hospital. That position meant that the package was very wide. Only later in time did a consultant cardiologist and consultant pulmonologist came up. In the initial phase there was already a heart monitoring department (CCU). Since we were on duty every other day, accessibility was essential. I lived about one and a half kilometer away from the hospital. We did not employ physician assistants.
My Bedside
One of the solutions that was devised: a cathode ray tube oscillograph on my bedside table. As said, it was long before the Internet. In short, it happened regularly that calls were made by the nurses at night. The suggestion to look at a certain heart rhythm on the oscillograph. Make a diagnosis and give an advise. Of course that all was somewhat limited. The green point on the horizontal line was less easy to interpret. I also had a FAX device and printed electrocardiograms were an alternative. The Electrocardiogram is only an aspect of the condition of the patient. But sometimes it was practical, especially when it came to non-threatening arrhythmias. But sometimes I had to go to hospital after all. This situation lasted several months, I remember. Over time, of course, the nurses became more and more able to assess ECG images themselves. But it was telemedicine ‘avant la lettre’.
Opportunities
This hospital experience means that I basically look positively at all kinds of developments that may not be so conventional. The Covid-19 crisis offers opportunities. The situation calls for unusual solutions. Even because of the large numbers of patients in various stages of the patient journey. Convince those involved is my mission. Who are obviously very busy in his fight. But give innovation somewhat space! Besides, it is very important to look at how a number of achievements can persist even after the crisis. Like the Stemoscope, the wireless stethoscope.
