Telemedicine: Speeding Access to Specialized Care

Telemed22300X200A new TeleMedicine Initiative is set to speed the availability of highly specialized care at SVMC.

TeleNeurology, the first of three planned telemedicine services, went online in April. It is expected to increase the speed of care for patients experiencing emergent neurological conditions.

“SVMC does not have a neurologist available 24 hours a day. Telemedicine allows us to access a board-certified neurologist whenever we need one,” said Trey Dobson, MD, a specialist in emergency medicine, chief medical officer at Southwestern Vermont Medical Center, and medical director of Dartmouth-Hitchcock Putnam Physicians. “That is going to make a big difference for patients experiencing stroke and other neurological emergencies.”

TeleEmergency services went online in May. Emergency telespecialists can be called upon to consult with SVMC’s board-certified emergency medicine doctors in the Emergency Department.

“The teleEmergency specialists can take over routine tasks that will keep our doctors and nurses at the bedside,” Dobson explains. “Additionally, for complex cases, we can quickly form a team using our own doctors and nurses along with those at Dartmouth-Hitchcock.”

Specialists for both services are physically located at either Dartmouth-Hitchcock’s Center for Connected Care in Lebanon, NH, which operates in partnership with telehealth leader Avera Health, or through a company called Specialist on Call, which uses doctors in locations nationwide.

The connection is made using a high-definition live two-way audio-video camera and a Wi-Fi-enabled monitor, mounted either to the wall or a cart. The camera is operated by the telespecialist and can zoom in to evaluate patients with enough clarity to determine whether or not their pupils are dilated.

Clinical staff at SVMC provide relevant health history and serve as a physical proxy for the remote physician. The telespecialists make recommendations and suggestions in collaboration with physicians at SVMC.

A third telemedicine service, for the intensive care unit (ICU), is anticipated to launch in the fall. TeleICU will provide 24/7 continuous monitoring by ICU intensivist physicians and nurses to support the work of SVMC’s onsite physicians and ICU staff. This will allow patients with more severe cases to stay at SVMC. In addition, the service provides SVMC staff access to education on the latest advances in intensive care.