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Electrodes in telemedicine help doctors diagnose from afar

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CARLSBAD, Calif. — Telemedicine is a way for an injured worker to immediately see a specialist who can properly diagnose and treat — factors that can improve outcomes, save employees from unnecessary treatments and save employers from unnecessary costs, experts say.

But for Carlsbad, California-based Emerge Diagnostics L.L.C., the trend is more technical than a doctor on a computer screen, said founder and Chief Scientific Officer Dr. MaryRose Reaston, whose firm uses sensors that go from patient to computer to internet to doctor to gauge one of the costliest and most mysterious ailments in workers compensation: soft-tissue muscle pain. 

“We have the ability to feel the patient through the screen,” she said, adding that the new practice fills a gap in telemedicine where patients see the approach as impersonal or disconnected. 

Dr. Reaston led a panel discussion Thursday on her firm’s approach to diagnosing and treating from afar at Emerge Diagnostics’ third annual Emerging Trends in Workers' Compensation Summit. 

Emerge Diagnostics specializes in testing for soft-tissue injuries by using electrodes to monitor nerve reactions to movement and other stimuli, creating a computerized reading of whether a muscle is in spasm or whether the nerves are reacting abnormally. 

The company started its telemedicine practice in Oklahoma in late 2015 and has since expanded to treating patients in four more states. This year it plans to expand into three more, according to Dr. Reaston. 

Dr. Frank Tomecek, a Tulsa, Oklahoma-based neurosurgeon working with the firm as an outside consultant, said the approach is gaining in popularity for its ability to pinpoint exactly where the pain is centered versus traditional subjective tests for pain, such as when a doctor asks a patient about their range of motion or how much pain they are in on a scale of 1 to 10.

On a large screen to his right was computer monitor screen shot of what looked like an electrocardiogram — only the zig-zags, some more pronounced than others, weren’t measuring heartbeats. They were measuring pain by taking readings from electrodes attached to the neck, shoulders and back, the most common sources of what he calls “mystery pain.”
 
“We can measure how much they can move and how much they can lift,” said Dr. Tomecek. “Before, I’ve never had the objective evidence I needed.” 

He said the approach also allows physical therapists to isolate problem areas immediately, and to better work with patients in improving range of motion and limiting pain. “Sometimes therapy can make things worse … with a misdiagnosis,” he said.