AcuteCare Telemedicine Blog


Advancing Availability and Quality of Stroke Care to the Underserved

The recent collaboration between AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals in the southeast United States, and the Southeast Alabama Medical Center (SAMC) is having its desired effect for SAMC patients, providing once unavailable, advanced life saving treatments to stroke patients. The Stroke Care Network, established in Dothan, Ala., in collaboration with ACT, the Southeastern Alabama Medical Center Foundation and the Alabama Partnership for Telehealth provides stroke services for a 240-square-mile swath and includes five “spoke” hospitals located throughout southeast Alabama, southwest Georgia and the Florida Panhandle.  The efforts have proven to be critical for stroke victim patients who were once underserved by the latest in life-saving technology.

The adoption and expansion of Telestroke, other acute Teleneurology support and Telemedicine applications has a significant beneficial impact for healthcare organizations, clinicians and patients alike.  Timely access to specialty Neurological consultations via Telemedicine, help many patients avoid the debilitating effects of strokes and other Neurological emergencies due to late diagnosis or delayed administration of “clot-busting” drugs.

Dr. Gwynn, ACT, Director and Founder of the Stroke Center of Northside Hospital and recent Chairman of the Department of Internal Medicine, says, “The new telemedicine health care model is an excellent vehicle to advance the availability and quality of telestroke care to patients who remain underserved throughout the region and all around the country.” In response to their success AcuteCare Telemedicine is making an aggressive push to help other hospitals and networks that don’t have immediate access to neurologists and other specialties.

Dr. Keith A. Sanders from AcuteCare Telemedicine and Director and Founder of the Stroke Center of St. Joseph’s Hospital of Atlanta, says, “We are planning on extending our successful telemedicine platform to an additional two hospitals before the end of 2013 and to an additional 3 hospitals during the first quarter of 2014 as more hospitals and health networks recognize the benefits of sharing specialist services without having to house them on-site.”



If “What” is the Point and “How” Gets Us to the Point, Does “Why” Really Matter?

Achievement of any goal or objective begins with the question: What’s the point?  The answer to the initial question sets forth the purpose for implementing an effort to move forward to an end, or an objective. How is the strategic means to achieving the objective and if the journey is successfully achieved, does it really matter “why” we set out on the mission from the beginning?

In a recent article by Ty Montague, CEO and co-founder of co: and author of “True Story: How to Combine Story and Action to Transform Your Business,” he expresses his views on the importance of “why” in terms of storytelling versus storydoing. Storytellers think of a story as the domain of the marketing team. A company’s story is thought to be separate from the corporate strategy and is most often expressed through advertising. Storydoers, on the other hand, think of their story as a strategic asset and a competitive advantage. The narrative of storydoing companies is advanced through every action they take and those companies tend to be on a mission to make the world a better place, a quest that transcends revenue development and maximization. Their customers see and feel this higher goal in everything the company does and it makes them magnetic, creating fierce loyalty in their customers. Leaders and associates of storydoer companies tend to find their work experiences richer and more deeply satisfying and growing evidence suggest that storydoer companies are more efficient businesses that perform better financially over time.

Perhaps the purest example of an industry of Storydoers is those who deliver the broad range healthcare services to their customers, or patients.  Undoubtedly healthcare is a business, a very expansive and lucrative business, and one which requires revenue in excess of cost, or profit, to survive, prosper and prevail in its mission.  But it remains an industry whose practitioners are overwhelmingly called to serve the profession because “why” really, really matters.

Dr. James M. Kiely, a partner in Atlanta Neurology, P.C., AcuteCare Telemedicine (ACT) and Medical Director of the Neurophysiology Departments at Northside Hospital and St. Joseph’s Hospital of Atlanta says, “I am so invigorated when I help a patient and help my Emergency Room (ER) colleagues. We make a real, immediate and meaningful difference every time we do our job. There are few people who can say that about their careers. I don’t like hyperbole but what we get to do every day for a living, rocks!”

“Why” matters.



AcuteCare Telemedicine Turns 3!

This October marks the third anniversary of AcuteCare Telemedicine (ACT). Over the course of its first three years, ACT has grown considerably during a period of significant change in the policy and industry of healthcare in America. The 4 Board Certified partners of ACT have retained a steady focus on their mission of filling a growing need for 24/7 neurology coverage.

Telemedicine has proven to be a burgeoning facet of the healthcare industry, with technological advancements and enhanced communications allowing providers to extend their reach over geographical boundaries to patients in need while simultaneously streamlining the healthcare delivery process and reducing associated financial and environmental costs. ACT has worked hard to stay ahead of the curve, offering the most cutting-edge solutions for saving lives in cases of neurological emergency.

Entering its fourth year of providing this expert neurological consultation via telemedicine technology to rural and underserved medical facilities throughout the Southeast, ACT looks forward to continued growth. As teleneurology continues to garner attention from hospitals as a practical and effective solution to neurologist staffing needs, the outlook for the company this year and beyond is extremely positive. “The message of ACT has really started to take hold in the healthcare community, and as our efforts for finding new hospital partners ramp up, we are optimistic that we will ultimately be able to reach even more patients with and offer them the level of care they deserve,” says Dr. Lisa Johnston, Partner, ACT.

“Following our rebrand of the company in 2011, we have stayed dedicated to our values as expert practitioners and our vision as a business,” adds Dr. Keith Sanders, Partner, ACT. “The standard of service we have been able to provide has only climbed higher. We are truly passionate about combating morbidity and mortality rates of acute stroke, right here at home in the Stroke Belt (a region of the Southeastern US with higher-than average stroke rates) and beyond.”

Hard work and diligence is paying off for the partners of ACT. As the group continues to practice neurology full time and commit themselves to reaching more patients in 2013, they hope to add to an already impressive list of achievements and accolades throughout their short history.

 



Insomnia: Limiting the Use of Sedatives and Hypnotics

Insomnia is the most commonly encountered sleep disorder or complaint, with a wide prevalence range reported to be between 10 and 40 percent  (the variance is due to differences in the definition of insomnia). Suffice it to say, millions of individuals are affected by insomnia at some point in their lives. Because of the significant increased rate of comorbidity associated with insomnia, the burden placed on society by way of increased utilization of health care resources, poor work performance, and missed work days, it is essential that insomnia is appropriately and efficiently managed.

Individuals who suffer from insomnia frequently seek help from medical professionals and this help is often provided in the form of a sedative/hypnotic medication. Significant risks are associated with the use of sedatives and hypnotics, such as dependency, falls (particularly in the elderly), and even an increase in cancer and death rates, as shown by a recent study. Prescription medications do have a role in the treatment of some individuals with insomnia, as well as those with conditions and situations that may call for temporary use, such as time zone changes and jet lag. However, these medications are often over prescribed and/or misused due to insufficient patient evaluation.

It is well understood that when evaluating a patient with complaints of insomnia, an underlying medical and or psychiatric disorder should be considered. Ruling out and treating underlying etiologies is requisite. With resolution or control of the causative medical or psychiatric condition, the insomnia will often times abate. When thorough evaluations are performed in the setting of insomnia, sedative use can be potentially limited, if not completely avoided.

Complaints of insomnia may also be indicative of another (primary) sleep disorder such as restless leg syndrome (RLS) and periodic limb movements (PLMs), delayed sleep phase disorder (DSPD), or obstructive sleep apnea (OSA). Sleep onset and maintenance difficulties may be the result of both PLMs and OSA. The inability to fall asleep at the desired sleep time will be seen in individuals with DSPD. Patients with the above conditions will frequently complain of daytime sleepiness, a complaint not usually expressed in individuals with primary insomnia. These sleep disorders can all be treated without the use of sedatives. Furthermore, the use of sedatives in these cases will only serve to mask and possibly exacerbate the primary sleep disorder, leading to increased morbidity and mortality rates.

In the July 2010 issue of SLEEP, a study was published showing that the prevalence of sedative use in the general Canadian population had more than doubled between 1994 and 2003. Interestingly, this increase had occurred moreso in men, non-elderly, and obese individuals. The study concluded that “the greater odds of sedative medication use found among morbidly obese men may reflect the presence of underlying obstructive sleep apnea, which may in turn serve to explain in part the known relationship between sedative medications and mortality.” When patients with untreated sleep apnea are prescribed sedative/hypnotic medications, apneic events typically worsen, setting up for poorer outcomes and placing them in danger of respiratory arrest.

When underlying etiologies of insomnia have been ruled out and sedatives are needed, they should be used sparingly and temporarily. When possible, alternative treatment modalities such as cognitive behavioral therapy should be employed to avoid or limit the use of sedative and hypnotic medications.