UH doctor leads task force on use of telemedicine

Full virtual exam aims to help triage patients ‘more effectively, secure needed care’

One out of five people experience dizziness at least once every year, according to University Hospitals.

The range of sensations can get so severe in some people that there are about 4 million visits for treatment of dizziness in U.S. emergency rooms every year.

Dizziness is a symptom that can be linked to a wide range of conditions, from something as relatively benign as dehydration to a chronic problem such as anxiety.

Conditions can also be far more serious, noted Dr. Aasef Shaikh, chair in brain health at the UH Neurological Institute.

“About 15% of those visiting the emergency room have devastating neurological conditions such as stroke or multiple sclerosis that require urgent attention,” said Shaikh, who is also a research scientist from the Cleveland Functional Electrical Stimulation Center at the Louis Stokes Cleveland Veterans Affairs Medical Center.

Shaikh recently led an international task force of experts to develop globally accepted, consensus-based guidelines to help emergency room doctors diagnose and triage patients with dizzy symptoms over a telehealth, virtual platform. The taskforce, consisting of two dozen expert physician-scientists from 10 countries, had its work endorsed and published by the International Society for Research in Cerebellum and Ataxias.

“There are very few doctors who have adequate experience to treat the complex problem of dizziness,” Shaikh said. “As our world is going through the crisis in a contagious pandemic, the doctors were strained in triaging their patients with dizziness based on new priorities.

“They had to determine which patients should be attended expeditiously and who could wait.”

According to officials, the task force offered two important tips:

1. How to identify a patient who needs urgent evaluation, expedited evaluation, or one who could wait to be seen in clinic at a later date.

2. How to evaluate a patient with dizziness using the virtual platform of telemedicine.

The guidelines were prepared in such a way that they become helpful for any healthcare provider working in the urgent care, emergency room or general practice, said Shaikh. In addition, the task force believes that telemedicine for patients with dizziness “will resolve many logistic issues” even after the novel coronavirus pandemic is over.

“There was an era before COVID-19, and there will be a different time after,” Shaikh said.

The task force also shared a word of caution, believing no matter how advanced health care systems become in using virtual platforms to treat patients, the human interaction of the in-person consultation will continue to be an important component in the healing process.

“The future guidelines for telemedicine should be informed by evidence that weighs up the pros and cons, personal versus telemedicine consultations,” Shaikh said. “Whatever the coming years will bring, it seems clear that telemedicine has received an immediate boost to its uptake with major implications.

“This could mean a major paradigm shift in favor of for time- and resourcemanagement in health care.”

“Whatever the coming years will bring, it seems clear that telemedicine has received an immediate boost to its uptake with major implications.” — Dr. Aasef Shaikh

Shaikh