Telemedicine robot comes to Ilwaco hospital

Evelyn Herndon, RN, Luz Greenfield, CNA, and Deborah Beach, RN, from left, confer with Valerie Mays, whose image is projected from the Telestroke robot monitor in Ocean Beach HospitalÕs emergency department. Mays is the program coordinator for the Providence Stroke Center in Portland. Ocean Beach Hospital is on the verge of implementing advanced video conferencing technology that beams regional stroke experts into the ER to help doctors immediately diagnose and treat stroke victims.

ILWACO — The resources of the big city are coming to the Ocean Beach Hospital in Ilwaco in the form of a health robot for fast treatment of stroke victims. The robot was on display Feb. 4 at the Women’s Heart to Heart gathering in Long Beach.

“Robot” is a bit of a misnomer as the device, which stands about six feet tall on wheels with a large monitor for a head, does not think for itself but is really more of a communication system. 

Denny Lordan, regional account manager for InTouch Health, which according to their website is the “world’s only telemedicine provider,” was on hand to manipulate and explain the device. 

“Well, maybe robot isn’t the best name for this device — what it’s really doing is providing a remote presence,” he said. Lordan was controlling the device, which did have an unnerving ability to turn its head-like monitor, speak and move around from side to side, from his laptop on a table across the room. 

Fast action critical in a stroke

This medical device is specially designed to assist stroke victims. A stroke is a condition in which a blood clot or ruptured artery or blood vessel interrupts blood flow to an area of the brain. Time is of the essence for stroke victims.

“We have about 4.5 hours to deliver medication that can prevent brain damage,” said Susie Fisher, RN, BSN, regional program manager for Providence and speaker at the event. “It’s not appropriate in every situation, but that’s what a skilled neurologist or physician can determine with the help of this machine.” 

The robot — part of the Providence Telestroke Network — was demonstrated at the Heart to Heart event at the Long Beach Elks Lodge as part of a special information workshop for women and heart disease. 

Basically the device, with the assist of a laptop and a wireless Internet connection, allows a doctor at a remote location to converse in real time with a doctor or patient at another location. 

Provided by Providence free

Providence Health & Services in Portland is part of a not-for-profit health system providing services in communities across five states: Alaska, Washington, Montana, Oregon and California. Headquartered in Renton, Providence continues the legacy started by the Catholic Sisters of Providence and the Sisters of the Little Company of Mary more than 150 years ago.

“Our mission is to help people wherever we can, and we are focusing on remote areas for this device,” said Fisher, who has been a nurse for over 24 years.

The robot is more than just a talking head. It has a stethoscope and EKG functionality and can display CT scans or other information that may be needed to make the correct diagnosis.

The beauty of the robot is that it can be brought directly to a patient’s bedside so that both doctor and patient at Ocean Beach Hospital can be in communication with a specialist at the Providence Portland hospital system. The monitor provides two-way communication, basically like a video-conferencing set-up with some important additions.

“The doctor at your hospital here can send a fax or an image — a CT scan for instance of a possible brain bleed — via this device and the doctor at Providence can look at the image in real time to help with a diagnosis,” said Lordan. 

“We call this ‘Telemedicine’ — this kind of system has the ability to provide a remote area with experts in any field. This device is for stroke, but we have others — one for dermatology issues for example.”

When asked “Why Ocean Beach Hospital?” Lordan said, “Well, Oregon has one of the worst rates of stroke in the country — we’re actually in a region called the ‘stroke belt.’”

Though southeastern states (primarily Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia) were originally labeled the “stoke belt,” in a May 2005 research document from the National Center for Chronic Disease Prevention and Health Promotion, Washington and Oregon were described as “new satellites of the stroke belt.”

 

Program talks began last summer

Alan Craft, Ocean Beach Hospital director of public relations & business development, indicated that the Tele-Robot fit into an expanded program for cardiac care that began at the hospital some time ago.

“We began talking with Providence about this program early last summer, and signed with them on Sept. 21, 2010,” Craft said. “Linda Kaino, our chief nursing officer, was the primary architect of this project. She worked with Susie Fisher, the Stroke Center’s regional program manager.”

  “We were actually in the process of developing a stroke program and had made inquiries at other organizations when Providence approached us,” he continued. “It was the solution we were looking for – they had already developed a program to service rural communities and it was an ideal match for Ocean Beach Hospital and the community we serve.”

The unique program provides real time diagnosis and treatment, which enables the Ocean Beach Hospital ER staff to consult immediately with stroke specialists. 

“It grants the neurologist the ability to visually and audibly assess a stroke victim,” said Craft. “In essence, the stroke neurologist can perform a full ‘virtual examination,’ including reviewing charts and patient records, as well as consulting with physicians and the patient’s family.” 

 

Telestroke equipment almost ready

According to Ocean Beach Hospital CEO Joe Devin, “We are in the final stages of setting up the Telestroke system.”

This new age of telemedicine is presenting its own complications. “We need to make sure that the doctors from Providence are registered to practice medicine in Washington state,” Devin said. 

Craft explained, “We have not yet enacted the Telestroke protocol system because the Providence doctors, who are in Oregon, are still waiting licensure in Washington state.” 

“This is a long process that takes a minimum of six-to eight-weeks, and the state currently is way behind schedule,” Craft continued. “First we thought we’d be up and running the first of January, then February. We’re still waiting.”

 

Free to patients

When asked about the fees to patients for this service, CEO Devin said, “At this time there is no charge for this service.”

Craft elaborated, “There is very minimal cost associated with the Telestroke program on our end. The primary cost is in the technology — the Telestroke Robot — which Providence is absorbing. No cost is transferred to the patient because of this program.”

When asked how the systen would work, CEO Devin said, “The consultation will be initiated by the staff or doctor after a patient has been admitted to the emergency room. It should be up and running in a couple of months.”

“We’re very excited about it. The fact that one of our patients can talk to a specialist should be very reassuring.”

Craft added, “This program will dramatically improve the outcomes for patients who do suffer a stroke in our community.”

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