While he was teaching at Yale Medical School several
years ago, David Spiro, M.D., a pediatric emergency physician, brought to class
still photos of some of his patients to illustrate their medical conditions and
explain how he diagnosed and treated them. A student asked him, “Why not
In response, Dr. Spiro shot some video of one emergency
room patient — a teenage girl who was breathing rapidly. Seemingly depressed
and potentially suicidal, the patient was thought by attending physicians to
have deliberately ingested an overdose of aspirin. But then one medical student
in the room noticed a very sweet smell on her breath and correctly diagnosed
her with diabetes. The patient was successfully treated for that condition.
|“When you see a 30-second shot of a real patient, and you have key points that are curated and edited by an editorial board, that is a powerful, powerful educational opportunity.”|
“My students said, ‘David, the lecture was great, but
that video case was unbelievable. Can you shoot more?’” Spiro recalls.
That’s how was born, with Dr. Spiro as its
co-founder and chief medical officer. The Portland, Ore.-based company, launched
in October 2013, is the first Web-based library of real patient video case
studies. Clinicians and medical students can access the library and search for
cases on specific conditions, including congestive heart failure, respiratory
distress and scarlet fever. All patients featured in the videos granted written
consent to participate in this teaching tool, and the videos are peer-reviewed
ReelDx is on the leading edge of a trend towards
asynchronous teaching in medical schools. Instead of spending 30 hours a week
in a classroom, students are doing more learning in an interactive, real-time
“When you see a 30-second shot of a real patient, and
you have key points that are curated and edited by an editorial board, that is
a powerful, powerful educational opportunity,” says Dr. Spiro, who also is a
faculty member at Oregon Health & Science University in Portland.
Sharing Learning Across Institutions
Armed with $179 Canon cameras, ReelDx’s participating
physicians videotape their patient encounters and then upload the video to a
secure website that is compliant with federal medical privacy laws. Individuals
or learning institutions can purchase an annual subscription to access the
library. Two medical schools on the East Coast are already using ReelDx in
their medical school curricula.
Dr. Spiro says he sees the library as an opportunity to
break down existing silos in healthcare that can prevent shared learning across
institutions. The videos help illustrate innovations in care delivery and best
practices at various hospitals nationwide that could be replicated elsewhere.
This is especially important in today’s changing reimbursement climate that
incentivizes providers to collaborate across the continuum of care and deliver
high quality care at low costs.
By improving the diagnostic acumen of medical students,
ReelDx can play a role in improving patient care and reducing unnecessary
medical tests and other interventions that don’t improve outcomes. Dr. Spiro
says he also envisions the video library being used to share novel treatments.
“This has been an unbelievable grassroots opportunity
to work with other pediatricians across Oregon and pediatricians and other
practitioners throughout the country,” Dr. Spiro says.
The possibilities for shared learning are not limited
by U.S. borders, either, because of its digital approach. The library already
includes content from clinicians in Tanzania, and plans are underway to expand
to other countries and continents.
“There’s this unbelievable opportunity to learn from
others and share what we are doing here in the United States,” Dr. Spiro says.
Ultimately, the focus of the company is patients, and
the job to do is improving their care by transforming the way medical students,
practicing physicians and other clinicians sharpen their diagnostic skills.
“I think ReelDx provides, if not real patient
experience, then close to real patient experience,” Dr. Spiro says. Students
and medical professionals are “hearing and seeing what’s actually
happening.” And because they are
watching it, they will retain it more than if they read it in a text book or
heard it in a classroom lecture.