It should make zero difference. Based upon the objective damage diagnosis that should lead directly to prescriptions for stroke protocols. But NO, your incompetent doctor doesn't even know what is being done to treat you. S/he is writing three prescriptions to OT, PT and ST saying E.T.(Evaluate and Treat). I think a doctor should be responsible enough to know exactly what stroke rehab is being done and the efficacy of that rehab.
Efficiency in stroke management from acute care to rehabilitation: bedside versus telemedicine consultation
Abstract
BACKGROUND:Telemedicine has changed over the last years, becoming an
integrated service used in various clinical settings such as stroke
units or radiological departments, but also as an important tool for
home rehabilitation. Assessment of usefulness and efficiency of
performing teleconsultations to manage stroke from acute care hospital
to tertiary care rehabilitation hospital has not been referred by
scientific literature.
AIM:This article analyzes the process of
discharging stroke patients from acute care to intensive rehabilitation,
based on the comparison between conventional bedside patient
evaluations and teleconsultation patient evaluations, to assess
efficiency and efficacy of two different discharging workflows.
DESIGN:Retrospective study.
SETTING:Consultations were carried out
between the Acute Care Stroke Unit (ACSU) and the Stroke Rehabilitation
Unit (SRU) of Valduce Hospital System.
POPULATION:257 stroke patients
underwent physiatric consultation during 2 years considered in this
study and 101 patients were considered eligible for intensive
rehabilitation treatment after a physiatric consultation.
METHODS:we
compared the efficiency and efficacy of the dismission workflow of
bedside medical consultation and teleconsultation over a 12 months
period. We considered the following outcome measures: time elapsed
between consultation and rehabilitation unit admission, number of
re-admissions to acute care hospital, complications occurred during
rehabilitation, length of stay in the rehabilitation hospital and
clinical outcomes of rehabilitation process.
RESULTS:we observed a
significant reduction in waiting time from the acute event to the
admission in rehabilitation department, an improvement in efficiency of
the admission process itself in the rehabilitation unit and a reduction
of clinical complications occurred during rehabilitation period, without
changes in rehabilitative outcomes.
CONCLUSIONS:it has been highlighted
that the use of telemedicine to perform medical consultation as a tool
to evaluate patients eligible for tertiary care rehabilitation hospital
admission from stroke care unit is feasible and more efficient when
compared with conventional bedside consultations.
CLINICAL
REHABILITATION IMPACT:this study reveals teleconsultations as a useful
tool to improve efficiency of the stroke management workflow.(Yeah when all you are doing is writing E.T. three times on a prescription pad there really is no need to even see the patient.)
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