A guest post from Dr. Cheryl Kerr, pediatrician and co-founder of ClickCare...

A few years ago, I was in the middle of an afternoon of patients when a 18-year-old girl came in with trouble walking.

L's Mom had dragged her into my office despite L's protests that she had probably injured herself at swim practice. When I asked L to walk down the hallway, I got chills. It sure didn't look like a twisted ankle: a classic part of the neurologic exam (walk on your heels) showed her right foot did not dorsiflex. My first impulse was deep concern because I really needed a consult. But from whom? An orthopedist? A neurologist? A neurosurgeon? The usual wait times to get in to see any of those specialists can top 8 weeks. Who should be first? Which specialty was most appropriate?

Luckily, I was able to use an early version of iClickCare to send simultaneous consult requests to the orthopedist, neurologist, and neurosurgeon. Within hours, when they had a chance to take a look at the consult, the orthopedist felt that since it was not an injury, another speciality might offer more. The neurologist, 2 hours away by car, offered to see the patient, but absolutely could not fit her into the schedule for a few months.  

The next day, the neurosurgeon operated on L, removing a spinal cord tumor.

When people ask me why we chose a "Hybrid Store and Forward" model for iClickCare's telemedicine platform, I always think of L. We chose this kind of collaboration (instead of teleconferencing, secure text messaging or any other platform) because it is the only option that allows: 

• Use of text, pictures, and video (crucial for sending a video of L's gait) 
• When-you-get-a-chance consults that let colleagues respond on their schedule
• No need to juggle time for video conference setup
• Simultaneous consults to let you ask questions of multiple folks -- in this case, an orthopedist, neurologist, and neurosurgeon
• Archiving of cases and media so that you can use them to teach and collaborate in the future

Curious how other providers use Hybrid Store and Forward telemedicine for medical collaboration and care coordination? We put together a free guide to pros and cons with a collection of case studies.

And for our overview of telemedicine options, advantages and disadvantages of different types, and a discussion of ROI: