Bringing doctors to you; Telemedicine remote care grows at WHS

By Richard Greene | Published Wednesday, February 7, 2018

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Getting Connected

GETTING CONNECTED – One of the telehealth carts at Wise Health System can connect patients with specialists remotely. Messenger photo by Joe Duty

When Lisa McDaniel’s 14-year-old daughter passed out in January and was taken to Wise Health System in Decatur to be checked out, she expected to make a trip to Dallas for her daughter to be seen by a specialist.

Instead, the hospital brought a specialist from Children’s Hospital to her through a high-definition screen. A doctor nearly 65 miles away in Dallas was able to order tests, review records and provide the same level of care as an in-person visit.

“They pulled a large screen at the foot of her bed and I sat next to her and was able to talk to the doctor,” McDaniel said. “It was almost like they wheeled a doctor into the room. When I had further questions, he ordered those tests also. It was just like being in the hospital with him.

“It saved us time and probably an overnight visit by the time we got there and did all the tests. I would recommend it.”

Through its growing telehealth options, Wise Health System is expanding the number of specialists available for patients and getting patients in front of health providers quicker.

“It’s the wave of the future,” said Amy Hermes, telehealth manager at Wise Health System.

The hospital currently offers telehealth care in seven different areas – TeleSpecialty, TeleNICU, TeleER, TeleStroke, Telepsychiatry, Bariatric telehealth and school-based telemedicine.

Using a cart with a high-definition screen and camera and the ability to attach stethoscopes and other devices, doctors can remotely interact with a patient and review symptoms and conditions.

“It’s audio and visual, so the doctor can actually speak to the patient, see the patient and interact with them,” Hermes said. “They have also have peripheral devices attached. Some of the carts can connect lenses to look in eyes, ears, nose and throat.”

No medical information is stored on the carts. Even pictures that are reviewed by physicians are temporarily shown on the screen to ensure the patient’s privacy.

“They are very HIPAA (the Health Insurance Portability and Accountability Act) compliant,” Hermes said.

Telemedicine can trace its roots to rural settings around the nation, where access to specialists can be limited. Patients in those communities would often have to be transferred or taken to hospitals in larger metropolitan areas.

“Sometimes you don’t have time for that,” Hermes said. “It can delay the care they need. That’s how it was formed – to extend the access to care and specialists in those small rural communities.”

Veterans Affairs health facilities have adapted new uses for telehealth to provide care for veterans. Hermes said the VA has provided a successful model for WHS and many others.

“In Decatur we’re using it because there’s a time you need immediate access, and we have physicians that are not always on the floor or even in Decatur,” Hermes said.

“If there is a change in [a patient’s] condition and they need a quick consult or they need a different specialist because something has changed, they can request a consult through telemedicine.”

Recent changes in legislation in Texas has allowed health providers to extend telehealth options to patients.

“The legislation in Texas used to say you could not have a telemedicine visit unless you first had an in-person visit with that provider,” Hermes said. “The law has changed in Texas. Now they’ve determined as long as you’ve met the same standards as a face-to-face visit through audio and visual connections that would qualify as your initial visit.”

WHS started last spring working with Bridgeport and Decatur ISD to provide school-based telemedicine. With parental consent, a school nurse can connect a child with a minor illness with a pediatrician, nurse practitioner or physician assistant.

“We use it as an urgent care setting,” said Holly Berry, the director of school-based telemedicine. “It’s to keep the kids at school and parents at work.

“There’s a lot of things they can see them for and try to keep them at school.”

For newborns in need of specialized care at WHS, the TeleNICU service gives the hospital, staff and families access to care similar to what they would receive at another facility. Hermes said it gives the hospital a chance to perhaps avoid a transfer of the newborn and add stress to a family.

“If we can consult with someone and that baby is able to stay here, that keeps the mom and dad from having to leave the hospital early and having to find travel arrangements, a place to stay and [figuring out] how to take care of the other kids at home,” Hermes said. “It’s really a community effort to try to make it more convenient for the parents and let them know their child is still receiving the level of care they would receive there but get to stay here.”

Through the TeleNICU, appointments can also be scheduled with specialists.

The nurse-initiated TeleStroke program has the ability to cut the time for a patient showing signs of stroke to get in front of a doctor.

“We have stroke neurologist that we consult with if we think it’s a possible stroke,” Hermes said. “With the stroke neurology, the goal of that is they can get timely diagnosis and treatment ordered to reduce complications and improve the outcome for stroke victims.

“With the ability to have a stroke neurologist look at the CT scans and the labs and assess the patients through telemedicine, which is audio and visual, then they can improve the number of people that can get that medication in that right time frame to improve the outcomes.”

Hermes said the options could continue to expand in the future as the service and use grows. It will mean even better care and greater convenience for patients.

“We are blessed with the number of specialists we have,” Hermes said. “To be able to connect with them when they are not even here is a huge blessing.”

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