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we were at 40 minutes. Now we're at 13
For stroke patients, in particular, time is
crucial. An estimated 30,000 brain cells die
per second following the onset of a stroke.
Assessing and treating the patient quickly
greatly impacts the victim's recovery.
With Remote Presence Robotics, the
technology is placed at the foot of the bed.
A physician or specialist logs in to the
system, giving him or her real-time and
instant access to the patient, the family
and EMS personnel. While talking to the
patient and the family, the specialist also
has the ability to zoom in on pupils, check
vital signs, obtain consent for procedures
and do whatever is necessary to get treat-
Currently, the only FDA-cleared treat-
ment for strokes is tPA---the clot busting
drug---which must be administered within
three hours of onset of a stroke.
Using telemedicine, "our goal is to
connect with a specialist within 15 min-
utes---and to get tPA started within an hour
of arriving at the facility," Ruiz says. "But
often it's much faster than that."
Making a Di erence in Rural Areas
Swedish piloted their program five years
ago with a grant to place the telemedicine
robotics in rural medical facilities, where
there may be only one or two doctors in a
single 25-bed hospital in the community.
Having access to neurologists and special-
ists made a major di erence in caring for
stroke patients in these rural areas, Ruiz says.
A large percentage of patients who would
have been transferred to an urban medical
facility have been able to stay in their own
community hospital. Since the onset of the
pilot, the program has had 475 consulta-
tions using telemedicine. In those cases, 46
percent of patients have been transferred to
larger medical centers, a significant decrease
in typical rural scenarios, Ruiz says.
Keeping patients in their community
hospitals, however, has not decreased pa-
tient tra c to the urban medical centers.
At Swedish Medical Center, referrals have
increased from 15 percent to 53 percent in
recent years, primarily, Swedish leaders say,
because of the reputation the medical center
has built by utilizing advanced telemedicine
as part of its daily operations.
"Word spreads," Ruiz says. "[The Remote
Presence Robotics] really helped to build
the reputation of Swedish and its stroke
Combating Skepticism With Results
When discussing implementation of the
program, initially, there was skepticism,
Ruiz says, with medical professionals curi-
ous about how robots could treat patients.
"Once they saw the technology and ex-
perienced it a couple of times, across the
board, people liked it," she says.
Improved physician morale may be an
According to Ruiz, neurologists typically
don't want to be the first or second neurolo-
gist in a hospital because they are worried
about frequently being on call.
"We're able to say 'our neurologist will
be on call and take the calls 24/7.' They love
that," Ruiz says. "A couple of our hospitals
have been able to recruit because neurolo-
gists would be relieved of that burden."
Now that treating stroke patients with tele-
medicine has become routine in Colorado at
the HealthOne facilities, the team is looking
toward the next area of medicine in which
to utilize the technology.
Behavioral health, eventually psychiatry,
is next on the schedule, Ruiz adds.
"Getting those evaluations done timely
(is a priority). Sometimes patients wait for
days," she says. "We definitely think psych
will be next, then perhaps pediatric sub-
specialties and emergency room uses.
"We've already added trauma to one of
our sites as a pilot," Ruiz says.
Understanding the implications of tele-
medicine is crucial for all health-care areas,
says Mary White, CEO of Swedish Medical
Center, especially as the FDA becomes more
involved with telemedicine vendors.
"When one of your customers comes to you
to buy equipment, such as cameras to set up
the system, [supply chain personnel] need to
be prepared to help them with optimal pric-
ing of items," White says. Education will be
key as choices continue to increase.
HealthTrust can help supply chain profes-
sionals navigate the process, and telemedicine
products will be reviewed in the near future as
a potential contracted category. For more infor-
mation, contact Mark Dumond, HealthTrust's
AVP Technology Services at Mark.Dumond2@
[ SourceBook ]
continued from page 15
"Our goal is to
connect with a
specialist within 15
minutes---and to get
tPA started within
an hour of arriving
at the facility. But
often it's much
faster than that."
20 Third Quarter 2011 | The Source
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