AcuteCare Telemedicine Blog


New Partnerships Bring Telemedicine to Guatemala

Recently the Georgia Partnership for TeleHealth (GPT), the Louisiana State University Health Science Center (LSU) and Casa Para Ninos Aleluya (CASA) launched its first international telemedicine program. The new partnership was formed through an ongoing relationship with former Louisiana Senator and Family Medicine Practitioner, Dr. Donald Hines and GPT’s Chief Executive Officer, Paula Guy.

The mission of the collaboration is to deliver much needed primary and specialized medical care to the children of the CASA orphanage through the use of telemedicine technology.  The orphanage is home to over 400 abused, orphaned and mistreated children and is located just outside of Guatemala City.  Started in 1988 by missionaries Mike and Dottie Clark, CASA’s vision is for the kids they serve to have a chance in life by bringing pediatric specialty care to the clinic in order to change the futures of these children and so many more.  The medical needs of hundreds of the children at CASA are met daily through a few nurses that manage a clinic on-site.  The new technology will greatly aid the on-site care givers capabilities in providing quality medical care to the children. The new technology has become a magnet for other missions who are struggling to serve the estimated 200,000 orphaned children across Guatemala.

The clinic was up and online within 24 hours and the nursing staff at CASA was trained and certified as telemedicine presenters and will be supported by Georgia Partnership for TeleHealth as they continue to serve Cuidad de Los Ninos.

AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals in the southeast United States, recently donated their time and expertise to make telemedicine a reality at CASA.  Dr. James M. Kiely, a partner in Atlanta Neurology, P.C., ACT and Medical Director of the Neurophysiology Departments at Northside Hospital and St. Joseph’s Hospital of Atlanta recently demonstrated the benefits of telemedicine capabilities at the orphanage.

Dr. Kiely remotely treated a 19 year old CASA patient with a history of intractable epilepsy. The young patient was on numerous medications but continued to experience recurring seizures. By using a high definition audio-visual connection provided by GPT, Dr. Kiely was able to interview the patient’s parents and examine the patient remotely. The imaging results, hemiparesis, and description of seizures allowed him to determine that the likely type and cause was attributed to porencephaly, the failure for one hemisphere of the brain to develop. Kiely was able to recommend appropriate medications to on-site doctors and to suggest additional steps to take if the patients epilepsy remained intractable.  The process worked flawlessly and marked the beginning of a new relationship between the missions and medical providers across the region.

Georgia Partnership for TeleHealth has aligned its mission to serve domestically and internationally and is seeing lives change through getting access to care in these underserved areas. There are no limits in providing this kind of access worldwide using technology,” states Dr. Jeffrey Kesler, COO of GPT.  The Partnership’s experience in implementing Telemedicine includes nursing homes, school clinics, correction, specialty clinics, Emergency Department, ICU, stroke assessment, primary care, child advocacy, and continuing education.

GPT will be providing ongoing support to the children of the Guatemala region through donated physician time. Physicians, who are interested in investing time to serve at CASA Para Ninos Aleluya, are encouraged to contact Matt Jansen, Executive Director, Georgia Partnership for TeleHealth at matt.jansen@gatelehealth.org.



Telemedicine Initiative Allows Remote Hearing Tests for Newborns

A report from Vanderbilt University, and an article published in Newswise.com, reveals a  telemedicine initiative at Vanderbilt’s Department of Hearing and Speech Sciences is working to make follow-up hearing tests for newborns more accessible in rural areas of Tennessee, while teaching young pediatric audiology and pediatric speech language pathology students to treat patients remotely.

Approximately 50 percent of children who do not pass hearing screenings at birth are later “lost to follow-up,” said Anne Marie Tharpe, Ph.D., professor and chair of Hearing and Speech Sciences and associate director of the Vanderbilt Bill Wilkerson Center.

Through a telemedicine initiative, Vanderbilt audiologists are conducting follow-up hearing tests on newborns with families that live in rural areas of Tennessee.

Tharpe’s group teamed with the Tennessee Department of Health for a pilot project to set up a remote site in Union City, Tenn., that provides follow-up testing for newborns, with a Vanderbilt audiologist in Nashville on the other end of the connection, acting as the hub site.

The technology allows the audiologist to take control of a remote computer during the testing and also interact with the family and technician as if they were standing side-by-side.

“This allows the clinician at Vanderbilt to control the system at the remote site using some simple secure software. Additionally, video-conferencing equipment with high definition cameras is used to provide clear real-time communication between the caregiver and the clinician,” said Devin McCaslin, Ph.D., associate professor of Hearing and Speech Sciences.”

Tharpe said one of the reasons these patients have been lost to follow-up is because families who live in rural areas have to miss work and drive into a city with a major medical center to do their follow-up testing.

“If we can provide this easily, and closer to their homes, then our hope is that once a baby’s hearing loss is confirmed through our follow-up testing those families will seek intervention services for their child” she said.

The initiative is made possible in part by two training grants totaling $2.5 million from the U.S. Department of Education and additional support from the Maternal Child Health Bureau’s Leadership Education in Neurodevelopmental Disabilities (LEND) grant to the Department of Pediatrics.

The training grant awarded to Tharpe is focused on providing training to graduate students who will work with deaf and hard-of-hearing children.  “Professionals are starting to investigate the use of telepractice, especially in rehab areas like ours, but to my knowledge no one is looking at how we train students to provide remote services, and I think that is an important component. What are the safety and ethical considerations and how do they differ from providing face-to-face care?” Tharpe said.



The VA Using Telemedicine to Expand and Improve Care to Veterans

The Veterans Affairs Department (VA) is changing the way it delivers health care to more than 8 million veterans.  The bureaucracy that has been struggling recently to provide services to more than 500,000 new beneficiaries, and who have demonstrated persistent difficulties in getting new veterans signed up for benefits, appears to be ahead of most health care providers in using technology to improve patient care.  The VA is now deploying a host of applications to expand its reach and make it easier for veterans to get care, no matter where they live.

The new mobile apps are rapidly changing how veterans access the resources and information that is available to them by engaging caregivers outside of the traditional office visit. Veterans can receive care through a telehealth program which uses Scan-Echo, a technology used to gather multiple care givers together to recommend a particular treatment plan. These technologies are helping create a system of care without walls, a virtual system of care.  The VA is making a huge investment in telehealth technologies, spending $500 million in 2013 alone on telehealth services, which include telemental health, telehome health and clinical consultation by video. Robert Petzel, VA’s under secretary for health, says, “This is where medicine is going, the virtual care delivery system.”

The VA has nine different technologies currently in use or about to enter the pilot stage which can perform functions like renew medications, communicate with their provider, look at their medical record information, such as labs, progress notes and radiology reports. A patient can utilize their iPad or smart phone to reorder medications or obtain other medical information on the spot.

The app is focused on giving veterans the knowledge to make better decisions and improve their quality of life.  It features a set of questions about the patient’s health history that, when answered, produces a summarized, personalized assessment of their current health status, their risk of major diseases, and the impact of their various choices will have on their health. The assessment calculates the risk of developing major disease, such as heart disease, stroke and diabetes so that the veteran can choose to change his or her lifestyle and recalculate the risks to see the impact those changes would have.  The VA developed the health living assessment program in response to both veterans’ and providers’ desire to have more tools.  Currently about 17 percent of all veterans are using telehealth services but it is estimated that 66 percent of all veterans could benefit from the technology services.



Study Reveals Telemedicine Improves Patient Outcomes

Researchers at UC Davis Children’s Hospital have found that telemedicine consults improved pediatric patient outcomes for patients treated in rural pediatric emergency departments that lack pediatric specialists.  They also found a physician was more likely to adjust the patient’s diagnosis and course of treatment after a face-to-face video conference with a specialist.   Madan Dharmar, an assistant research professor in UC Davis’s pediatric telemedicine program and the study’s lead author said, “The shortage of physicians in rural communities isn’t going to be solved by increasing the number of physicians, but by increasing the number of physicians available over telemedicine.”  “Telemedicine is going to be the future.”

Researchers examined data collected from five rural California pediatric emergency departments from 2003 to 2007. The EDs were equipped with uniform telemedicine technology, which was met with some resistance at first.  “Some of the rural doctors [who] were old-school at first resisted using the technology but when their objections were overcome they used it and liked it.  To aid the adoption process, UC Davis doctors conducted periodic test calls to check in and help the rural doctors adjust to the technology.

The face-to-face communication was responsible for improved outcomes, according to James Marcin, director of the UC Davis Children’s Hospital Pediatric Telemedicine Program and the study’s senior author. “More time is spent on a video consult than a phone consult. Rural doctors asked more questions and UC doctors provided more recommendations when video conferencing. “The technology is readily available,” Marcin said. “There’s no excuse why it shouldn’t be used.”

Only 3% of pediatric critical care specialists live in rural areas, serving the 21% of U.S. children who live in those areas.  Expanding the availability of specialized care to these children should be a priority for all communities and healthcare providers. The benefits of telehealth are increasingly being recognized all around the country. A bill recently sponsored by state senator Arthenia Joyner will make Florida the 20th state to require private insurers to cover telehealth services.