The Importance of a Pictorial Medical History in Assisting Medical Diagnosis of Individuals with Intellectual Disabilities: A Telemedicine Approach

摘要

When face-to-face physical medical exams are not possible, virtual physical exams, in the form of a pictorial medical exam/history, can be substituted, and telemedicine can be the means to deliver these virtual exams. The goal of this work was to determine if presence in the form of a visual and/or pictorial medical history can be of benefit to clinicians in the diagnosis of medical conditions of individuals with developmental disabilities (DDs) and/or intellectual disabilities (IDs), in particular those who cannot, because of their cognitive and/or physical disabilities, verbally relate their illness to a clinician. Virtual exams can also be useful in cases where clinicians may need additional advice from fellow experts, especially if those experts are not physically present.A web-based telemedicine application used for treating persons with DD/IDs was developed. This application includes a visual medical history component incorporated into an electronic medical records application. The purpose is to allow the clinician to use an environment that integrates a written and visual representation of a patient’s medical history and physical findings to aid the clinician in determining a medical diagnosis.Twenty-two clinicians and five direct service aids of a New York State Developmental Disabilities Services Office facility, who deliver healthcare to DD/ID patients on a daily basis, accessed the telemedicine application instead of their traditional hardcopy/paper medical history when examining patients. A comprehensive survey was distributed to the clinicians to determine the effectiveness of the application as well as help answer the primary questions proposed by this research.The results of this study showed that presence in the form of a video medical history is preferred by clinicians rather than having just a written medical history of the patient. Clinicians felt the visual medical history component of the telemedicine application was useful and informative for delivering healthcare to individuals with DD/ID and enabled them in diagnosing a patient as well as lessened the need to transfer patients to the emergency room, resulting in a significant cost savings.