In emergency departments, the sickest and most seriously injured get treated first, while less acute patients sometimes wait to see a physician. Now, The Johns Hopkins Hospital is providing medical screening exams to those patients faster, thanks to a custom-made telemedicine cart that helps off-site clinicians assess patients and initiate care.

Patients who are screened this way are taken to a treatment room in the Emergency Department for an examination in front of the cart. The connection, established before the patient walks in, lets the off-site doctor or physician assistant talk with the patient and move a camera that’s on top of the screen. Meanwhile, a certified nursing assistant in the Emergency Department can use a hand-held camera to zoom in on wounds and peer into ears, eyes and throats. A stethoscope placed on a patient at The Johns Hopkins Hospital sends the sound of a heartbeat across miles.

Clinicians who are not in the hospital have access to Epic, the electronic medical record, which holds patient histories and can store images, videos and other information gathered during the technology-enabled consultation. 

As a bonus, patients can see their own eyes, ears and throats in real time, boosting participation in their own care.

More than 1,500 Emergency Department patients have been screened this way since April 2, when The Johns Hopkins Hospital added the telemedicine cart. Now, similar carts are coming to the emergency departments of Johns Hopkins Bayview Medical Center and Howard County General Hospital.  

Individual telemedicine projects have been started across Johns Hopkins over the years. Doctors at Howard County General, for example, connect with nurses in local schools to diagnose ailments like ear infections in consultations that also loop in parents. Other doctors use technology to virtually visit elderly patients in their homes or provide home video therapy sessions.

The Office of Telemedicine, created July 1, is developing and supporting a robust and connected telemedicine program, linked by a single electronic health record across the Johns Hopkins enterprise. As a result, more patients can avoid the travel associated with seeing a Johns Hopkins doctor for consultations, second opinions or routine visits.