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 video?”

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 ReelDx 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 for accuracy.           

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 environment.

“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.

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