One of the most fundamental, and perhaps most difficult, skills to learn as a physician is how to tell when a patient is sick. That sounded absolutely ridiculous to me the first time I heard it, some time around the start of medical school.

But as I’ve progressed through my training, I’ve finally come to understand what that means – being able to triage patients quickly and safely. While much of that is grounded in thought on a purely intellectual level, a lot of it is an instinct based on seeing and talking to the patient.

So any technology that lets me do that sooner and more efficiently seems like it would be a valuable asset, which is why I was very interested when I came across the Transport AV platform from GlobalMedia, being used by the Cincinnati Children’s Hospital Medical Center. As described by GlobalMedia,

The GlobalMedia Transport AV telemedicine system combines the TotalExam examination camera, a handheld high-resolution video camera about the size of a dry-erase marker, and a digital stethoscope, microphone and headset all connected via the internet from the ambulance to CCHMC. Transport teams use the TotalExam examination camera to send real time live video and freeze-frame images of the patient to the doctors back at CCHMC.

Completely integrated into the gurney used by the ambulance, it is an innovative, not to mention pretty cool, way of extending medical care from the hospital to the field.

Working at a tertiary care facility, we get a lot of transfers from other hospitals. In admitting these patients, I quickly learned that these patients often do not turn out to be quite what they were billed to be. For example, in the hours it often takes to physically move a patient from one place to another — critical changes in the patient’s status can occur. The ability to see these patients en route – to talk to them, get a sense of how “sick” they are – could potentially be quite an asset. Integrating this system with a mobile platform for physicians (iPhone 4 perhaps?) could allow me to repeatedly check-in, learn about changes in status, and even simply start building a patient-physician relationship.

One can see how this type of utility could prove to be even more useful for emergency medicine physicians — who could triage and assess patients more efficiently and accurately with this type of capability.

Now to be perfectly honest, I can’t speak to the reliability, cost, or other operational details of the system. But deficits in those areas can be fixed in time. What this product is, at the very least, is a relatively innovative way of extending expert medical care from the confines of the hospital into the field – all the while emphasizing the whole patient rather than deconstructing them into a set of vitals and problems.