Well-Being//

How Telemedicine is Changing Healthcare During Disasters

I’ve provided care in plenty of urgent situations, but never while hurricanes raced over my patients’ homes.

Image courtesy of Unsplash.

I have been practicing pediatrics for more than 20 years and in that time I have seen a lot, but the afternoon of Saturday September 9th was unprecedented. I was in Pennsylvania while Hurricane Irma was battering away at Florida and Southeast Georgia. Even though I was hundreds of miles away, the evidence of the chaos she wreaked on my patients was twenty inches away from me.

I saw it from my computer screen, I could see a wheezing child in Yulee, Florida, a six- year-old with a fever at a hotel in Kissimmee and a four-year-old girl having trouble breathing during a mandatory curfew in Orlando.

How did I see them on my computer? I was scheduled to work a routine shift the next day as part of Nemours CareConnect. The pediatric telehealth service offers families live-video visits with a board-certified pediatrician over a smartphone, tablet or the internet and is available anywhere in Florida and Georgia, 24/7. Doctors can perform an exam and should the child need medication, geo-location services built into the phone or tablet can identify the pharmacy nearest to the family.

When it became clear that Hurricane Irma would have a devastating impact on the southeast, leaders from Nemours Children’s Health System immediately arranged to offer CareConnect at no-cost to families in Florida and Georgia in the days around Hurricane Irma.

I had been checking on my own family in Georgia and Florida when the clinical team texted me if I could see a few patients right away. Nemours had shared the offer of free CareConnect services on their social media channels and a record number of families shared that news, creating a level of demand we had never previously experienced.

Some families were preparing to evacuate their homes and others had already left. From my home office, I began to perform exams, discussing likely diagnoses and treatments with families, some of whom were in hotels, parking lots or living rooms. At times when no artificial light was available, resourceful parents set up the virtual visit in the backyard during daylight or used with flashlights for problems that could not wait until morning.

Anyone who has spent decades in pediatrics has provided guidance to a family without transportation, electricity, hot water, telephone or internet access. More recently I have provided plenty of care advice during urgent situations over Nemours’ telehealth platform. What was new for me was practicing in both venues as a hurricane raced over the homes of patients.

Primary and urgent care offices were closed. Emergency rooms were open but largely inaccessible during high winds and heavy rains. During the storm many communities issued curfews. Parents caring for a sick child needed to factor in access to health care for the child. Rapid access to a diagnosis and medical care plan from an experienced board-certified pediatrician was of great value to these families.

I held a video visit with the mother of a four-month-old who had a high fever. The child was born with a birth defect of the urinary tract and the infant’s pediatrician told the mother that if the baby had three days of high fever, the child needed an urgent physical exam. During Irma, the child’s regular pediatrician’s office and urgent cares were both closed and while the mother could see a nearby hospital from her window, the bridge linking her to that hospital was closed indefinitely.

Thanks to the public outreach by Nemours, the mother was aware of the telehealth option and registered her baby. I was able to perform a physical exam and then consulted a Nemours subspecialist. Together with the family, we developed an alternative care plan that involved extra doses of medication. This allowed the baby and mother to stay safely at home during the storm. Like so many parents I connected with through CareConnect, they were quite grateful for the service.

Because Nemours has providers spread through six states, we were unique position to respond to this crisis. When power outages impacted providers in Florida, our team in the Delaware Valley, who had already been licensed to provide care in Florida, was able to quickly offer support.

But the Florida-based teams were busy. Often they balanced their CareConnect duties with putting up plywood over their windows and buying bottled water and candles. It filled me with even greater respect for my fellow associates and reminded me of something we say often at Nemours: We do whatever it takes.

Beth Shortridge, MD, is a general pediatrician who cares for children in many locations including through Nemours CareConnect urgent care telehealth services.

After graduating from Duke University School of Medicine, Shortridge completed her pediatric residency at Thomas Jefferson University Hospital and is currently a volunteer assistant faculty member of Sydney Kimmel Medical College.

Shortridge has more than twenty years’ experience in pediatrics including telemedicine urgent care, community hospital care and outpatient care. She has practiced most of her career in the Philadelphia area and has been with Nemours for ten years. 

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