Hartford Business Journal

12 HARTFORDBUSINESS.COM | JUNE 26, 2023 Medical assistant Stephanie Orozco demonstrates virtual technology used on patients at DOCSNow in New Haven, with the help of New Haven site manager Marinet Soto (seated), while Dr. Jasdeep Sidana looks on and reviews the footage via a laptop. HBJ PHOTO | MICHELLE TUCCITTO SULLO Health Tech A new wrinkle to telemedicine: virtual-care clinics By Michelle Tuccitto Sullo msullo@hartfordbusiness.com A s medical assistant Stephanie Orozco puts an otoscope in a patient's ear in New Haven, Dr. Jasdeep Sidana, seated at his computer in another location, can see live images inside the ear canal. He can see any signs of infection, make a diagnosis and prescribe medication — without ever being physically in the same room with the patient. All patient-doctor interactions take place virtually at a new business Sidana launched earlier this year, a medical office called DOCSNow at 926 Chapel St., in New Haven. "This concept as a standalone is absolutely unique, and it's the first in the state of Connecticut," Sidana said. "If I am a physician sitting in East Haven, I can see patients in any location." Patients at the New Haven clinic sit in an examination room with a technician, who uses Food and Drug Administration-approved technology from virtual care company TytoCare to capture medical data and imagery. Patients can talk to the doctor via video while seeing the same live images the technology captures on a large television screen in the examination room. Patients still check in at a front desk and go to an examination room, where their vitals are taken. The only difference between this and what customers routinely expe- rience at a doctor's office is that the provider is virtually seeing patients with the help of technology. Medical assistants at the clinic also use special hardware that allows the doctor to listen to a patient's lungs and heart, or view the inside of their throats, for example, all in real time. The physician can then recommend treatments and write prescriptions. Sidana's DOCS Medical Group has locations around the state — including in Bridgeport, East Haven, Hamden, North Haven, Southington and Waterbury — providing both in-person and virtual care. DOCSNow in New Haven is the first brick-and-mortar, virtual-only model the business is piloting. Sidana asserts that a high percentage of patient visits can "absolutely be done as well" virtually as in person. But he also acknowledges the limitations: you can't give someone stitches or an injection virtually. He plans to hire nursing staff to provide in-person services like these. The clinic can also refer patients to its sister locations, where on-site doctors can perform such procedures. The virtual-only DOCSNow clinic is also not for emergencies. If a 70-year-old arrives with short- ness of breath and low oxygen, DOCSNow staff would call 911 and tend to the patient until emergency personnel arrive. "This is not to replace in-person care 100 percent," Sidana said. "It is to give patients an option and an alternative." Leveraging technology Sidana said he sees potential for expanding the virtual-only care model, and is looking at more poten- tial locations in other urban areas that could attract more foot traffic. Another DOCSNow location could open as soon as late 2023, he said, though he declined to specify where. He also sees potential expansion using this technology in schools and businesses. "We are able to leverage tech- nology so we can examine an indi- vidual while they are at their job and can call in medication and prescrip- tions," Sidana said. "I look at this as something that should be available in malls and at rest stops." Marinet Soto, site manager in New Haven, said the TytoCare devices and technology are "the new wave of medicine." "This (New Haven clinic) is the first virtual-only location," Soto said. "The patients like it — it is downtown and in the center. We are starting to get patients who are regulars." Dr. David Emmel, a physician and ophthalmologist who chairs the legislative committee for the Connecticut State Medical Society, said he isn't aware of any other virtual-only clinics. The society supports telemedicine, and Emmel noted that it was used a lot during the COVID-19 pandemic. However, Emmel said an ongoing patient and physician relationship is critical to the well-being and successful diagnosis of patients, and he expressed some reservations about the virtual-only clinic model. "What if there is an acute problem and a trained physician isn't there to do tests on location?" Emmel said. "If a physician isn't there, such as phys- ically palpating a patient, symptoms can be missed. A virtual exam is not the same thing. It makes me nervous." Care whenever, wherever Telemedicine has been used for years, with physicians meeting patients virtually via video chats and telephone, computer or electronic device. In 2021, approximately 37% of adults had used telemedicine within the past 12 months, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. Dr. Pamela Hoffman, medical director of telehealth services at Yale New Haven Health Services and Yale Medicine, said Yale has been using tech- nology for virtual visits since well before the COVID-19 pandemic. Through Yale's Video Care OnDe- mand telehealth service, patients can use their smartphone, tablet or personal computer to see a Yale New Haven Health clinician for a variety of minor, non-emergency medical conditions, from sinus infections and pink eye, to skin conditions, rashes, colds and the flu. Through the service, Yale clini- cians can diagnose symptoms and prescribe medication. Patient visit details can then be shared with primary care providers. Pamela Hoffman

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