When Flu Season Hits the ER, Telemedicine Offers Surge Capacity

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Across America, influenza patients are crowding hospital emergency departments, clinics and doctors’ offices.  A recent article in California’s Mercury News proclaimed,”Flu deaths rise, patients pack Bay Area emergency rooms: ‘All hands on deck, the doctor says”. In San Diego, one emergency department was so overcrowded the hospital set up an outside triage tent.

Why is this epidemic overwhelming healthcare systems?  First, this year’s vaccine provides less protection against the current strain of influenza than usual, with its effectiveness estimated in the range of 30%. Second, a more virulent flu strain arrived earlier than usual. So, the epidemic is occurring with greater severity and earlier than anticipated.

As sick people flood healthcare facilities, telemedicine is playing an important, but perhaps unrecognized role, by providing surge capacity. As Chief Medical Officer at First Stop Health, I monitor the volume and nature of our calls.  Not unexpectedly, First Stop Health doctors are diagnosing and treating a rapidly increasing number of influenza cases.

For most adults, the flu can be diagnosed and treated via telemedicine. For diagnostic purposes, fever and cough are the most common symptoms. When influenza is epidemic, a clinical presumption that any patient with fever and a cough, has the flu.  Adults younger than 65 with mild illness and no risk factors do not require testing before treatment. Of course, the specific treatment provided to every patient must reflect the doctor’s judgment.

In treating the flu, the rapid access to physician consultation provided by telemedicine is of particular value.  Unlike the common cold, antiviral medications are effective against the flu. However, treatment must begin early (preferably within two days and not more than five days) after the onset of the illness.  For effective flu treatment, speed matters. Telemedicine eliminates the travel, waiting, and potential for spread of highly-communicable influenza, associated with an office or ER visit.  Early treatment significantly shortens the duration and lessens the severity of illness.

Consultations with First Stop Health physicians are available to members, their spouses, and dependents, 24 hours a day, 365 days a year via telemedicine.  This epidemic demonstrates the value of the continuously accessible care provided by telemedicine.  When the illness strikes at night, or in some instances even during the day, the only available facilities for many people are hospital emergency departments.  24/7 telemedicine service provides a fast, cost-effective solution to this need for round-the-clock care.  It enables treatment while avoiding unnecessary visits to overcrowded, high-cost, hospital emergency departments.

Much was written about the role of telemedicine in offering care after the hurricane-related tragedies in Texas and Puerto Rico. Now, as we face a virulent epidemic, the value of telemedicine, in providing surge capacity is evident as well.


Mark L Friedman MD FACEP FACP is the Chief Medical Officer of First Stop Health, a Chicago-based telemedicine provider. He is Associate Professor of Emergency Medicine at the Frank Netter School of Medicine. He was formerly Chief of Emergency Medicine at St Elizabeth's Hospital of Boston. Dr. Friedman is a graduate of the college of the University of Chicago and the Pritzker School of Medicine. He was a Kron Scholar at the University of North Carolina’s Kenan Flagler School of Business. He is a Fellow of the American College of Physicians and a Life Fellow of the American College of Emergency Physicians.

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