Telemedicine is rewiring health care, especially in rural areas where a limited number of physicians are available and specialists are at an even higher demand.
With new rules passed in September, Mercy Fort Smith is planning to expand its high-tech telemedicine program and link satellite clinics in rural west central Arkansas with Arkansas board certified specialists at the new $54 million Mercy Virtual Care Center in Missouri.
The approval of a revised Regulation No. 2.8 cleared the way for providers to connect patients via virtual visits by allowing a doctor-patient relationship to be established through an examination conducted using real-time audio and video technology that provides at least as much information as the doctor could obtain through an in-person examination.
Dr. Cole Goodman, president of Mercy Clinic, said the new rule helps increase access to health care specialists for people in rural areas since they will not have to drive or be driven to Fort Smith. Patients will be able to see specialists like a pediatric cardiologist at Mercy Virtual in Chesterfield, Mo., from local clinics in Booneville, Ozark, Paris and Waldron as well as Fort Smith. Electronic medical records aid in the speed of care being offered.
While Mercy has put investments into its telemedicine abilities for over a decade now, starting with Mercy SafeWatch in 2006, the new state rules will also allow Mercy to roll out its Virtual Hospitalists program. This offers a team of doctors at Mercy Virtual who will be able to see patients at Mercy hospitals and clinics in Arkansas.
Hospitalists work around-the-clock using virtual care technology and can order needed tests or read results. Mercy Fort Smith currently has access to Mercy Virtual Care Center for stroke care and burn trauma. And Mercy’s clinics have telemedicine connections to Mercy Fort Smith.
At the touch of a button on one of Mercy’s mobile ICU carts, using technology like OnStar’s but with a video monitor, a call is made to a stroke specialist at Mercy Virtual in Chesterfield, Mo., near St. Louis. The eICU carts have high-definition cameras that can zoom in on the patient, as well as otoscope and stethoscope attachments that allow the medical specialist on the other end to get accurate readings.
With just a three-hour window to give the clot-busting TPA drug for strokes, telemedicine care is seen as something that can “bridge the gap” between physician access and patient need, according to Nicole Harp, the stroke program coordinator at Mercy Fort Smith. Rebecca Palazola at Mercy Virtual said Wednesday over the eICU monitor the stroke center at Mercy Virtual gets up to 22 calls a day although some days they have received as few calls as one.
Having electronic records on the same system speed up the process. Otherwise the records must be printed off and faxed in to the physician.
Harp explained that telemedicine as it is known today, with all the high-tech bells and whistles, simply improves the precision in making a diagnosis from afar. Prior to these advancements, descriptions of vital signs and symptoms often came down to just how good the health care provider was at describing something to a specialist.
“It’s a big deal,” Harp said of telemedicine’s capabilities. “There’s an increasing number of patients but not enough physicians.”
Harp also said patients in rural areas are more likely to get follow-ups at their local clinic, rather than drive to Fort Smith, and that increases compliance and often leads to better outcomes.
When it comes to health care access, Scott County is listed by the Arkansas Department of Health as one of the most underserved counties in the state. According to Primary Care Health Professional Shortage Area scores, Chicot and Woodruff counties are the only two counties more underserved.
Mercy Virtual currently offers Home Monitoring continuous monitoring for more than 3,800 patients, intervening when needed. This is said to reduce the patients’ need for hospitalization and helps them live independently longer, the Mercy website states.
Sparks Regional Medical Center participates in a University of Arkansas at Medical Sciences-led program called AR SAVES (Stroke Assistance through Virtual Emergency Support).
“Our hospital is equipped with telemedicine technology, that allows not only for training for personnel, but real-time video communication to enable a neurologist to evaluate whether emergency room physicians should use a powerful blood-clot dissolving agent within the critical three-hour period following the first signs of stroke,” a Sparks news release states.
Sparks also has the capability to use telemedicine for patients within the emergency department. Several Sparks physician specialists have telemedicine devices in their clinic offices to consult on patients in the hospital including the Cardiology Center at Sparks and Sparks Neurology Center.