How telemedicine can reduce emergency room visits

- With the help of a smartphone or tablet, patients can now have a doctor's appointment on their couch or pretty much anywhere.

"It's about keeping up with the times but also meeting patients where they are," said Jason Rogers, the manager of the app lab at Mount Sinai Hospital.

Mount Sinai is one of the several hospitals nationwide working to combine telecommunications technology and medicine, telemedicine for short. Over the years, countless apps connecting patients to doctors through chat rooms and video chat have been launched.

"We want to make sure we're using secure technology, that we're not accidentally going to share patient information on unsecured channels," said Dr. Nicholas Genes of Mount Sinai Emergency Services. He regularly uses telemedicine in his emergency room. He said that connecting online with patients is extremely convenient for those who have complaints that could be managed with minimal exams.

"It's any way to interact with a healthcare provider -- doctor, nurse, case manager -- interacting with a patient through technology," he said.

Telemedicine also helps doctors connect with one another. In the center of the nursing station is an iPad that doctors use to connect with one another to discuss other patients.

"They can call us, we can establish a two-way video link and then we can assess the patient ourselves and make recommendations for avoiding an emergency department visit," Dr. Genes said.

Mount Sinai's Dr. Fredrick Thum said, "Every patient that is able to be seen via telemedicine, that we're not seeing in the emergency department, we're happy about that."

Still, Dr. Thum and Dr. Genes said that any time technology is involved you have to wary of the downsides, too. While some patients could be diagnosed with a stuffy nose or a headache over video chat, others need in-person medical attention.

"If a patient were to call me and say they were having chest pain and they had high-risk features I would urge them to come into the emergency department," Dr. Genes said.

"You don't want someone at home to be using telemedicine as a substitution for a 911 call or a visit to a hospital," app lab manager Rogers said. "But with the right information gathering, you can avoid that and get the person where they need to be."

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