The moment a stroke patient arrives in the emergency room, doctors spring into action — the countdown is on and as every second passes, neurons are being suffocated. That's why having a stroke …
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The moment a stroke patient arrives in the emergency room, doctors spring into action — the countdown is on and as every second passes, neurons are being suffocated.
That's why having a stroke expert available at all times is a necessity. But what happens when the expert is outside of the hospital?
UCHealth Highlands Ranch has a solution: Telehealth.
Through the hospital's Telestroke program, an expert can connect with patients and on-site doctors in a matter of seconds via video. As the patient undergoes a CT scan, the doctor can begin a physical exam through a screen on wheels—a machine known around the hospital as “Jarvis.”
“Time is tissue,” said Dr. Ben Usatch, medical director of the hospital's emergency department. “If you don't get them treated quickly, people die.”
Telestroke is just one part of the hospital's initiative to integrate technology throughout its healthcare system. Other programs include virtual urgent care visits — so patients don't have to leave their homes to deal with illnesses like the flu — and virtual monitoring to help prevent things like infections or falls from bed.
The goal of such programs is to connect affordable, easy care to patients while freeing up doctors to spend less time on clerical work and more time with sick people, said Dr. Christopher Davis, UCHealth system's medical director of virtual health.
“Healthcare has a problem. We have skyrocketing costs and an aging population,” Davis said. “The whole idea is: Can we use technology and innovation to scale the health care needs of our country? That's what we're all about here.”
Davis spoke with a Colorado Community Media reporter one afternoon in early December via a “virtual visit” set up through the hospital's smartphone app. After a list of questions was completed through an online form, Davis appeared in the video feed, wearing a headset and sitting in the Virtual Health Center in Aurora.
In any given day at the center, there is one physician, one advanced practice provider, three to four critical care nurses and 17 technicians, he said.
“We're making a bet that digital health is the wave of the future in health care,” Davis said. “We want to be on the leading edge of that curve.”
The video feed is clear enough for conversations and even a look into a sick throat if needed. Patients can use these visits for things like a cold, a UTI or pink eye.
In these urgent care visits, doctors are usually looking to see if a prescription is needed. While the providers won't write scripts for controlled medicines such as opioids, they will write them for antibiotics or steroids.
Some primary care clinics and about 15 subspecialties within the hospital system also allow virtual visits.
Outside of about 15 video visits every day, the virtual health care center also monitors the vitals of about 1,000 patients daily.
Through machines attached to the patients, the health center receives data on respiration rates, heart rates, blood pressure, oxygen saturation and skin temperature.
Nurses are required to take these measurements every four hours, but between those time periods, a lot can change with their patients, said Katrina Doyle, a UCHealth charge nurse. With the vitals being updated every minute, nurses get notifications about changing vitals much quicker.
“It's like an extra nurse,” Doyle said. “I think it's good.”
One focus for the hospital is to reduce the number of deaths caused by sepsis, or a life-threatening infection. Similar to strokes, every minute counts when a patient is experiencing sepsis, making early detection vital.
Through this new program, patients with sepsis are treated about two hours quicker, Davis said.
If those in the virtual health center see that a patient is in danger of sepsis, they can call a nurse and see if they need help beginning treatment. If the nurse is swamped with other patients, the virtual helper can begin administering antibiotics from their desk in Aurora.
Kathryn McCune, 63, a UCHealth patient diagnosed with pancreatic cancer, was admitted for trouble with her liver. After a few nights with the vital-checking equipment, she said she was grateful for the technology.
“I think it's great,” she said. “Last night there was a couple times when it went off…the nurse was here in a matter of seconds to check on me.”
McCune is also diabetic and it gives her peace of mind to know that if her blood sugar is abnormal, it will be detected promptly.
While nurses still get vitals every four hours, even in the night, it's not as invasive and she can get better sleep, she said.
Techs at the health center also watch video feeds of about 35 other patients per day who are at risk of falling.
In the past, patients in need of monitoring—usually elderly people—required someone to sit in the room with them. Now, one person in the virtual health center can watch 10 people at a time, keeping an eye out for restlessness, tugging on IV's or attempts to get out of bed.
When they spot this, they can speak into a microphone that feeds into the room, asking them to wait while a nurse is notified.
While some in the medical community have expressed concern about introducing this much technology into healthcare, Davis doesn't share their worries. In fact, a big part of his job is working to change the hearts and minds of doctors who don't want to take medicine in this direction, he said.
“Robots aren't going to replace doctors,” he said. “But doctors who use robots are going to replace doctors who don't.”
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