AcuteCare Telemedicine Blog


Extreme Telemedicine and the Urgency of Now

January and the New Year bring the Consumer Electronics Show, an exposition of tremendous scale where the newest and flashiest concepts and prototypes for technological marvel are put on display for the public. Innovation in medicine was a hot-button topic at this year’s show, as more and more attention has been focused on the state of the US healthcare system.

There is a new television commercial from a leading innovator in communications technology making its rounds. A segment of the ad shows a group of climbers on a snow covered mountain communicating with a doctor on a tablet computer. The doctor is explaining how to set the apparently broken leg of one of the members of the crew. This 5 second scene, interspersed with other vignettes displaying the company’s visions for the future of its technologies, is an intriguing and exciting flash forward into the vast potential that telemedicine holds for the future.

Of course, one could imagine countless such scenarios in which powerful telemedicine will eventually play a game-changing role. We are on the cusp of a huge revolution in medicine, fueled by relentless innovation like that on display at CES or in the television spot.

The fact of the matter is that telemedicine has already brought this future to our doorstep. While the ‘dreamers’ consider what capabilities advanced technology might ultimately unlock, many physicians are already working with very advanced tools to address issues that are urgent now. For AcuteCare Telemedicine, the focus remains on offering sustainable and highly effective resources to deal with the increasing prevalence of stroke and other neurological emergencies. Through means made possible by telemedicine, ACT is already hard at work shaping the future of the fight against this epidemic.

Allocating resources towards new and innovative technologies and practices is an important part of creating tomorrow’s healthcare culture equipped with the right tools to care for patients. But it is also imperative that until we achieve that goal, we concentrate on applying the amazing technology already available to us to focus on the task at hand. In solving today’s problems, we set the stage for a better understanding of where to go next.



AcuteCare Telemedicine in 2013: Cutting Edge Neurological Care, Anywhere

Following a third consecutive year of growth in 2012, AcuteCare Telemedicine (ACT), an Atlanta-based partnership of 4 board-certified neurologists, is expanding its efforts to become the leading provider expert neurological care to rural and underserved areas throughout the Southeastern United States via cutting edge telemedicine technology.

Telemedicine, once regarded as an exciting new frontier, has now been fully realized as a part of the mainstream lexicon of medicine as we enter 2013. For a large number of hospital systems, telemedicine programs are now becoming a mandate as the nation faces a growing shortage of specialized physicians.

ACT has established itself as an innovator on the forefront of the industry, taking a unique approach to telemedicine by leveraging new technologies and techniques to enable personal neurology consultation when doctor and patient are in different locations. ACT offers a broad range of customizable services including 24/7 emergency neurological consultation and support programs for facilities seeking Joint Commission accreditation as a Primary Stroke Center, but primarily specializes in telestroke: the application of telemedicine to the treatment of the acute stroke patient. With the help of ACT’s powerful and personalized services, patients throughout the ‘Stroke Belt’ states of the Southeast have drastically improved access to the care they deserve, and medical facilities increase efficiency while reducing the costs associated with maintaining a traditional emergency neurology staff.

Whereas many hospitals with existing neurology departments simply do not have the resources to maintain around-the-clock clinician capacity, ACT has managed to successfully disrupt the trend and bring patient and physician together, regardless of geographical boundaries. Achieving this goal requires a certain level of investment in technology and trust in the people behind it. ACT is truly technology-agnostic.  This agility affords healthcare organizations with the ability to select the platform that meets budgetary and organizational parameters.

ACT provides access to the best 24X7 acute neurological care. Contact Michael Woodcock to hear how teleneurology can impact your business and patients in 2013.



Long Distance Learning

Along with other massive changes brought on by the increasing power and reach of the internet, the past decade has seen a drastic increase in the number of undergraduate and graduate degrees attained online. Today, more than 12,000 different “digital degrees” can be obtained from accredited U.S. universities, a figure that has grown by double digits annually for the last five years.

While the growth of the internet has enabled a plethora of such ‘distance learning’ opportunities for collegiate education, new technologies and practices in telemedicine are simultaneously reinventing the approach to professional education in hospitals and healthcare facilities around the world.

The educational aspects of telehealth programs demand the least effort and level of investment of any implementation of the discipline, but the benefits of adoption are immense, and can serve as the building blocks for increased engagement down the road.

Telemedicine actually allows hospitals to bring the education directly into the facility, offering professional training directly from the experts on the newest procedures and protocols, as well as serving as a 24/7 resource always available for consultation.  Bringing this type of program into a hospital not only helps administrators, physicians, nurses, and staff better perform their jobs and offer patients a better standard of care, but also creates champions of the telemedicine services, opening the door to a healthcare ecosystem that is far more responsive to innovation.

Introducing telemedicine to healthcare facilities through educational initiatives is also a great way to align the goals of the hospital and the provider to foster stronger relationships for the future. The facility wants to offer top quality care within the confines of a tightening budget, and the provider wants to help its client hospital save lives while reducing spending in the process to demonstrate its competitive advantage. The educational process is a great way to interface with the effective and efficient solutions that telehealth can offer. It is a major step towards a future where all hospitals have access to the resources they need to operate equally efficiently; a win for patient and provider alike.



Telemedicine in the Wake of Natural Disaster

As October 2012 came to a close, the arrival of Hurricane Sandy served as a haunting reminder that we can never underestimate the destructive and disruptive power of nature. The “superstorm” wreaked havoc on some of the most populous areas in the United States, not just causing billions in physical damage, but severely testing our infrastructure and its vital role in our society.

Considering the major implications that storms or other disaster events on this scale have for the healthcare industry, the days leading up to, during, and following Sandy were a demanding exercise in preparation, planning, and execution. The storm left countless citizens in need of medical attention, and threatened the adequate treatment of those already receiving care.

As one major resource put under the stresses of a disaster-level storm, hospitals and other healthcare facilities quickly became incapacitated by overcrowding, understaffing, a broken supply chain, and in select cases, power failures that crippled essential equipment. A small contingency of Mobile ERs were dispatched across the region, but a lack of pure manpower hindered the effectiveness of the efforts. Despite their mobility, the interrupted transportation systems within the affected communities prevented many from reaching the help they sorely needed.

Telehealth is an ideal candidate for addressing the challenges of these kinds of circumstances. The infrastructure of telemedicine is capable of delivering expert direction and attentive care to victims of natural disasters. The question of manpower becomes a negligible issue, as doctors and other respondents can call in from anywhere, and thanks to ever increasing internet access, the reach of the care administration is not limited by the victims’ location.

If emergency management agencies and telecommunications service providers are willing to work hand in hand with healthcare professionals, we now have the tools and knowledge to ensure that in future disaster scenarios, people can always have the support they need.



A Shifting Attitude

Telemedicine’s role in the current healthcare environment has been blossoming over the course of the past few years, making progress towards the full realization of the field’s potential.  A certain percentage of healthcare professionals are already there; those who have seen telemedicine at work day in and day out already know that we are providing patients with excellent care, mitigating costs to the healthcare system, and saving lives. The challenge remains getting the rest of our industry and our patients up to speed.

Improving care standards and lowering health care costs are their own rewards, but also important is the evident change in the way people think about getting medical treatment. Telemedicine is significantly changing patient behavior. We have heard astonishing figures – flirting with near 100% satisfaction rates – when it comes to positive experiences for both hospital workers and patients.

Presumably, an estimated 20% of the roughly 140 million ER visits that hospitals bear each year are able to be treated virtually. That number jumps to around 70% when considering urgent care centers and primary care physicians. The aforementioned shift in attitude about how to best access care in emergencies and non-emergencies is crucial to opening the door for telemedicine to alleviate much of the burdens these unnecessary visits place on the system. Reducing the stress on physical and financial resources also means better care across the board when patients do come to the hospital.

The speed, efficiency, and improved coordination of care are all great assets for a society battling with the challenges of an inefficient traditional healthcare system. The good news is that the many advantages of telemedicine for payers, providers, and patients are truly beginning to take root with the public, and driving behavior that will lead to even better results down the road.



Good Things Come in Small Packages

As the fall approaches and we reach the third anniversary of AcuteCare Telemedicine, we have spent some time reflecting on our company and personal growth over the last three years. From simple beginnings, serving one health care facility in the metro Atlanta area, ACT has expanded to include facilities in rural communities of both Georgia and Tennessee. We have developed alliances with Emory University Hospital and the Georgia Partnership for Teleheath, two partners who enable us to provide the highest quality of acute neurologic care where it may otherwise be lacking. Turning our attention forward, ACT continues to push to ensure that every emergency department is staffed with adequate 24/7 neurology coverage, whether in person or via remote presence.

ACT has always believed that our successes are primarily due to the quality of services we offer. Despite our expansion over the past three years, ACT has remained a small, intimate company, still owned and operated by its four founding physicians. We find unique value in our size; it allows for outstanding continuity of care, frequent “meetings of the minds,” and quick, effective identification of problems and subsequent solutions.

Weekly meetings with all four physicians cultivate innovative ideas, enable problem identification, and facilitate the creation of solutions in a timely and efficient manner, advantages rarely possible in larger corporations. Thanks to the size of the company, each physician of ACT has a specific role, but can be flexible and share duties when needed, strengthening the consistency of the quality care we provide.

Being smaller has other rewards. In the world of acute neurological emergencies, there is little time for complex communication and red tape. When problems or concerns arise at any of our serviced facilities, an ACT physician can immediately make contact remotely and work directly with a facility member on issue resolution. Try calling up the CEO of your car’s manufacturer when your check engine light comes on.

The four physician-owners of ACT continue to practice neurology in a group that has been caring for patients for more than 65 years combined. We are highly trusted neurologists in our own community, and we are committed to bringing our expertise to other communities in need. Our small size ensures that we will stay focused on keeping our standards high and our integrity intact along the way.



ACT Partner Taylor Regional Hospital Embraces Technology for Better Care Standard

AcuteCare Telemedicine (ACT) partner Taylor Regional Hospital in Hawkinsville, GA is on the cutting edge of revolutionizing healthcare in underserved areas in rural parts of the Southeastern US.

Lacking the fiscal and logistical resources to implement the comprehensive services found at larger facilities in urban centers, Taylor Regional has openly embraced a wealth of new technologies to drastically improve the quality of care it offers patients within its surrounding communities.

Choosing ACT’s 24/7 teleneurology services was an elegant solution to a major deficiency facing the hospital. Taylor Regional has no neurologists on staff, and the nearest available specialists are located more than an hour away. Prior to the partnership with ACT, the hospital lacked the capability to effectively diagnose and treat stroke-causing clots, often having to transfer patients to a larger hospital, compromising crucial ‘door-to-needle’ time and reducing potential hospital revenues.

Through the adoption of beneficial programs such as the telemedicine services offered by ACT, the hospital has not only taken strides forward in treating patients internally, but has also enhanced communications with other facilities, connecting with other physicians for consultation and collaboration as well as streamlining transfer processes to ensure patients receive timely and expert care.

Most recently, the teleneurology services provided by ACT resulted in the administration of tissue plasminogen activator (tPA) in two separate cases of acute stroke at the facility in the month of August 2012. The two successful administrations of the clot-busting agent are a significant achievement, serving as a milestone for a teleneurology partnership that has now successfully extended this potentially-life saving service to residents of the counties surrounding Taylor Regional.

“We are very pleased with our partnership with ACT. The neurologists are extremely professional and eager for our telemedicine program to make a real difference in the care we are able to extend to our stroke patients,” commented Lynn Grant, Emergency Room and ICU Nurse Manager, Taylor Regional. “ACT is available 24/7, taking the time not just to be there for the patients, but for our physicians, nurses, and staff, answering questions and educating about the technology and techniques that are helping us save lives. Having this service is very rewarding.”

“Taylor Regional Hospital is on the cutting edge of emergency stroke care in rural Georgia. ACT has been particularly impressed with their clinical judgment, leadership and organization,” said Dr. James Kiely, Partner, ACT. “Their community is well served.”

For more information about ACT, visit www.acutecaretelemed.com.



Its Black and White: A Neurologist Saves the Gray
November 3, 2011, 6:06 pm
Filed under: Telemedicine | Tags: , , , , ,

Time is brain. Every minute during a stroke 2 million brain cells die. Starved of oxygen, neurons die when a blood clot blocks an artery. The outcome is disability and even death.  Administration of the “clot-busting” drug Alteplase (i.e. thrombolysis) within 3 hours can restore blood flow and brain cells…life. Neurologists, at the core of an acute stroke intervention team, can save brain by saving time.

The gold-standard for measuring the efficiency of acute stroke care is the time “from door to needle.” That is, the time from when a patient arrives to the emergency room to the time medication is infused with a goal of <60 minutes. However, for a neurologist to truly minimize disability a cascade of crucial steps must begin in the field with Emergency Medical Services (EMS). The emergency room (ER) must stand ready at all times to accept and treat an acute stroke.  Meanwhile, the coordinated efforts of laboratory, radiology and pharmacy staff will determine when, or if, life-saving medication is given.

Neurologists, particularly Directors of Stroke Services, are charged with the responsibility of putting a coordinated plan into place ahead of time. Stroke outcome improves when EMS notifies the ER that they are transporting a possible thrombolysis patient. Subsequently, meeting the stroke patient at the ER’s ambulance bay for immediate transport to the CT table can result in door to needle times of less than 20 minutes. Assuring stroke patient’s blood samples are given priority in the laboratory, alerting the on-call radiologist before the CT is completed and premixing thrombolytic drugs in the ER are also crucial steps in an efficient acute stroke intervention.

Neurologists also benefit future patients by rigorously reviewing the outcomes of previous stroke interventions. Scheduled meetings of a multidisciplinary “stroke team” reinforce good practices and identify inefficiencies. Ultimately, patients benefit because neurologists are taking leadership roles in the planning and implementation of acute stroke care.