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How Telemedicine is Saving Lives

Telemedicine

Telemedicine gives emergency patients at rural medical clinics almost instant access to the expertise of specialists located hundreds of miles away at teaching hospitals or urban hospital complexes.

In the United States and countless other countries, medical professionals are using the cutting-edge technologies of telemedicine to save lives that might otherwise be lost. Rapidly gaining acceptance both here and abroad, telemedicine puts the expertise of medical specialists within easy reach of the patients who need it the most.

In a recent posting on the Congress Blog at TheHill.com, Jacqueline Corley, M.D., chronicles a typical example of telemedicine’s life-saving capabilities at work. Dr. Corley, a neurology surgery resident at Duke University Medical Center, tells how a neurointensivist making the rounds in Duke University Hospital’s intensive care unit responds to a pager call alerting her to a consult with a possible stroke patient at a remote hospital location.

Specialist Examines Patient

Responding immediately to the pager call, the neurointensivist quickly makes her way to a quiet room located in a corner of the hospital’s ICU. Activating a computer with a webcam, she brings up a crystal-clear image of the stroke patient lying in a rural hospital bed far from the Durham, North Carolina, campus of Duke and its medical center. She can see that the patient has one arm hanging at her side like a dead weight. She also notes that the patient’s face “seems stuck in a twisted, sad expression.” Whether the patient’s contorted facial expression is a product of a stroke or anxiety remains to be determined.

Speaking into the microphone of her computer’s webcam, the Duke neurointensivist calmly speaks to the distant patient. “Hello, ma’am. I hear you are experiencing some new symptoms. What seems to be the problem?” After this introduction, she methodically but swiftly gathers details about the patient’s medical history and the onset of symptoms of this most recent emergency. She directs the patient to perform a battery of physical exam maneuvers, such as lifting her arms and raising her eyebrows. The Duke specialist also asks the patient to name a variety of common objects in order to better judge whether the patient is suffering from any cognitive deficits.

Telemedicine

In the photo above, an emergency room/ICU nurse manager at a regional hospital in Hawkinsville, Georgia, acts as intermediary between an emergency patient in her care and a medical specialist in Atlanta via a telemedicine hookup.

Treatment Plan Mapped Out

Within five minutes, the Durham-based neurology specialist has gathered all the information she needs to confirm that the patient she is examining has suffered from a stroke. And based on that remote visual exam and verbal exchange with the patient, the Duke neurointensivist is prepared to advise the medical team attending the patient on just how to proceed with her care. This rapid-fire response to a medical emergency, such as a stroke, cuts down on the time between the patient’s appearance and the emergence of a treatment plan based on a stroke specialist’s expertise.

Handled the old-fashioned way, the patient would have to be transported from a rural medical clinic or hospital to an urban medical center with neurolgy specialists on staff. Telemedicine allows rapid remote evaluation by relevant medical specialists. In Dr. Corley’s words, this “rapid triage and medical decision-making . . . can save hours in a world where minutes make all the difference.”

Improves Stroke Care

Stroke care is one of the areas where telemedicine has made the most significant difference in the speed with which an appropriate treatment plan can be mapped out. As Dr. Corley points out, once a blood clot clogs an artery that supplies the brain and a patient begins to show symptoms of a stroke, “a metaphorical hourglass is turned, and every minute that passes means increased risk for permanent damage.” Expert evaluation of a possible stroke patient via telemedicine speeds up the process considerably, saving both lives and brain cells that might otherwise be lost.

Telemedicine is helping healthcare providers in other areas as well. In a July 2015 posting on the MeMD Blog, writer Zana Alattar reports on how telemedicine is helping to save lives amid the civil war that has raged across Syria since early 2011. The country’s health care infrastructure has been literally torn apart in the past few years, reports Alattar. As of mid-2015, more than 600 of the country’s medical personnel have been killed, and hundreds more have fled the war-torn country. On top of that, most of the country’s health care facilities have been damaged or destroyed by “deliberate or indiscriminate attacks.”

Telemedicine Aids Syrians

To help fill the healthcare void created by the ongoing civil war, writes Alattar, the Syrian American Medical Society, a U.S.-based humanitarian nonprofit, has turned to telemedicine. The SAMS’ telemedicine program connects health care providers on the ground in Syria with physicians and medical specialists in the United States. “In complex trauma and intensive care, frequent cases in war-torn Syria, specialists based in the U.S. can connect with technicians and nurses via video cameras, Skype, and satellite internet to provide valuable medical advice that they would otherwise not have access to.”

Alattar also notes that the SAMS telemedicine link between the United States and Syria allows U.S.-based nephrology and dialysis specialists to share their expertise with counterparts in Syria. While Alattar acknowledges that the SAMS telemedicine initiative barely grazes the surface of this massive health care crisis, she notes that it “shines a light on the means by which people abroad can make a difference.”

Telemedicine in the intensive care unit setting can also reduce mortality rates at major medical centers, according to research conducted by Matthew McCambridge, M.D., at the facilities of the Lehigh Valley Health Network in Pennsylvania. Dr. Cambridge, a pulmonologist and specialist in critical care medicine, and colleagues found that 24/7 telemedicine monitoring of ICU patients cut death rates by nearly 30 percent and decreased ventilator use in critically ill patients.

Telemedicine

If a consulting neurology specialist can determine that a stroke has been caused by a blood clot rather than a bleed, he can quickly advise those caring for a distant patient to administer a clot-busting drug.

Improves Quality of ICU Care

LVHN’s intensive care units are staffed by critical nurses and specially trained physicians who work on-site. In addition, patients in the network’s ICUs are monitored 24/7 from an off-site control room known as the advanced intensive care unit, or AICU. From the AICU, specially trained nurses and physicians watch over patients during the nighttime hours and work in tandem “with bedside caregivers to detect problems sooner, provide faster treatment, and ensure the highest level of care at any hour.”

As beneficial as telemedicine’s technologies have been for health care providers and patients in the United States, it has shown even more dramatic life-saving potential in some remote and medically underserved areas of the world. Dr. Corley notes that Médecins Sans Frontières, or Doctors Without Borders, has used telemedicine extensively in recent years to provide doctors working in the field with easy access to expert medical consultation when needed. As of 2015, the international medical aid organization had logged more than 1,300 telemedicine calls from nearly 250 referral sites all over the world. The top referring countries using the organization’s telemedicine portal have been the Central African Republic, Malawi, and South Sudan, according to Dr. Corley.

If you’d like to read additional articles about telemedicine and the ways in which it is reshaping the delivery of health care worldwide, check out related articles in our blog.

Don Amerman has spent more than three decades in the business of writing and editing. During the last 15 years, his focus has been on freelance writing. For almost all of his writing, He has done all of his own research, both online and off, including telephone and face-to-face interviews where possible. Don Amerman on Google+