Case Study: How a Telehealth Physician Uses Text Blaze to Provide High-Quality Care

I am an Internal Medicine and Emergency Medicine board-certified physician who works both in an emergency room and for a chat-based virtual medicine company.

As a Telehealth physician, I strive to provide high-quality, accessible, and affordable medical care to people throughout the continental United States.

With the ability to log in through a computer or smartphone, virtual care has broken down geographical barriers to accessing medical care. It brings the physician to the patient at the convenience of the patient.

There is a significant amount of medical care that can be safely provided virtually.

Chats and photographs for urgent medical problems, chronic medical conditions, and behavioral health, for example.

Lab tests and imaging studies can be ordered electronically and reviewed virtually, and precriptions can be electronically-submitted. Web-based links to medical education allow the patient to read about their diagnosis and treatment in detail. Home monitoring with glucose testing, electronic blood pressure cuffs, cardiac monitors, and oxygen meters have helped the virtual medical field flourish.

Having Valuable Conversations Effectively

In a chat-based virtual platform, the value of the conversation is the quality and depth of the discussion between the clinician and patient.

We need to communicate that we understand a patient’s condition, determine a diagnosis, and rule out any features that suggest a severe illness that needs to be seen in person in urgent care or an ER.

What is not of value is the time it takes to free type every phrase, and this is where Text Blaze has been a game changer for medical chat.

In order to improve the efficiency with which medical information can be provided to patients through chat, a few of my colleagues and I have collaborated to build a library of snippets using Text Blaze.

While much of the chat is a freely typed conversation, the snippets are designed to enhance the flow of the discussion with the patient by adding common phrases easily through a few keystrokes.

For example, I usually work in the morning so my personal introduction is three key strokes:

However, if working in the afternoon, a greeting can match the time zone of patients across the country:

When opening a new case virtually, quite a lot of detail has already been provided by the patient through a questionnaire. Being able to efficiently and accurately summarize the key elements ensures that I confirm with the patient that I understand their condition and there is no miscommunication or missing information.

For example, for an eye infection, filling in a few Text Blaze fields summarizes the information the patient provided prior to connecting with me, the physician.

Providing High-Quality Virtual Care

Here's a common scenario: A female patient may request a virtual care consultation for a urinary tract infection or UTI. Snippets allow me to quickly confirm the date of their last UTI and the antibiotic used:

I then confirm basic information answered in a questionnaire, recommend an appropriate antibiotic, and provide antibiotic dosing and instructions:

Nearly 100 commonly prescribed medications are abbreviated as "/Rx+the first few letters in the medication’s name." Take the antibiotic Ciprofloxacin can be applied topically or as eye drops, ear drops, or pills.

I can also send a link about UTIs for the patient to read. For patient information, I use links written by my company and also publicly accessible links by the medical database UpToDate. Between these two resources, there are over 100 links that the clinicians can easily drop into the chat.

Finally, rather than type out the reasons to be seen in person for a given diagnosis, all common urgent care diagnoses have a "/er + diagnosis" snippet. For urinary tract infections, it is /eruti.

While I value the efficiency and low cost of virtual care, not every condition can be managed through telemedicine. For patients who need to be seen in person but are uninsured, there are snippets with links to Federal and State health clinics and low cost dental clinics:

Creating a Central Repository of Accurate Information

My virtual care colleagues and I use a shared snippets folders. Changes to snippets are automatically shared by all clinicians. If a new medication is added to the list, dosing and instructions are updated. If a policy-related change is made, these changes automatically populate the Text Blaze account of my fellow physician and nurse practitioners.

For example, certain States require the first meeting with a patient to include a face-to-face introduction by video.

If a State were to remove this requirement, I can change the snippet accordingly, and it will disseminate to all my colleagues.