No doubt about it. Telehealth is all the rage and presents tremendous potential for expanding access to quality care for a multitude of patients. The technology, which connects patients and physicians via high speed video connections, promises to expand access to all types of medical care in rural areas, as well as providing enhanced access to specialists for those in need, even in urban areas. But it is not a panacea. Some news is best delivered in person. So, when a California hospital wheeled a video device into a man’s room to tell him he was dying, we can assume it did not go as well as intended.

Clearly someone didn’t think this all the way through. 

Earlier this month, a nurse wheeled what the family described as a “robot” into the ICU of the Kaiser Permanente Medical Center emergency department in Fremont, California. According to the family, the “robot” told 78-year-old Ernest Quintana that his time was up, and there was nothing they could do. He was apparently told, “you might not make it home.”

We will elaborate and opine on this in a moment. First, however, is a point in this story that was quite annoying. The family involved persistently referred to the device as a “robot,” and the reporter seemingly embraced the term, with the headline of the article reading, “Family upset after ‘robot’ doctor informs patient he doesn’t have long to live.” There are numerous quotes about the robot; the robot wasn’t loud enough, they had to ask the robot to repeat itself, the robot said this, or the robot said that. They seemed to believe that it was actually a robot they were speaking to.

It wasn’t a stupid robot. They were speaking to a doctor through a video interface.  

Still, from a “human touch” perspective I would chalk this up as a complete fail. I am not sure how it could have been worse, unless the family was asked to put more quarters into the machine because they were running out of time (literally). At least there weren’t commercials in the broadcast (Coming up; You’re going to die, but first a word from our sponsors!). 

The family recorded part of the exchange, and I must say, watching the two-minute video below was harder than I thought it would be. While the doctor speaks of comfort for the patient, the starkly cold chill of a video monitor delivering devastating news to a family doesn’t sit well.

The hospital, in its defense, claimed that a nurse always accompanies the video display – not to hold a patient’s hand and comfort them, but instead to explain the purpose of the technology. They also added that the machine visit was a follow-up to earlier physician visits. It is unknown whether any of those in person visits delivered the fatal diagnosis. The family’s reaction would make one think that was not the case.

In all seriousness, who thought this was a good idea? The concept of telehealth is great, but to wheel a video display in to deliver a message of doom somewhat degrades the positive potential of the technology. No one wants to be told by some guy in Mumbai that they’re about to die. It’s a stick in the eye. And that is no lie. 

It shows us that we have some learning to do when it comes to deploying innovative technologies. No single concept is an answer to every problem. In this case it seems pretty clear to me. Using remote doctors to deliver news of a person’s imminent demise doesn’t come close to registering on the “warm and fuzzy” monitor. That is a job best left to a human in the room, thank you. The moral of this story is, don’t send a video screen to do a man or woman’s job. That can be a real kick in the groin for telehealth.

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