3 - weinstein - telemedicine applications - jan 14 2019 ... - weinstein...•gap services •urgent...
TRANSCRIPT
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Clinical Applications
Ronald S. Weinstein, M.D.
Director, Arizona Telemedicine Program
© 2015 Arizona Telemedicine Program
Major Categories of Services in General Usage
•Gap Services
•Urgent Services
•Mandated Services
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Teleradiology – 1,300,000+ cases
Emergency Medicine – Banner HealthCourtesy, Debbie Dahl, EE
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eCareMobile
Correctional Facility
ClinicseED
Stroke Neurologist
Trauma Surgeon
Nephrologist
Psychiatrist
Initiate TX asap
ED
Referring sites
Tele-stroke
Trauma triage
Tele-psychiatry
Specialty call coverage
Intensivist & Hopstialist
ED
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Courtesy of Debbie Dahl, R.N.Banner Health
iCare BGMC MedSurg LOS
0
1
2
3
4
5
medical surgical
Average LOS (days)
0%
5%
10%
15%
20%
25%
medical surgical
LOS outliers (%)
Pre (2008) Post (2010)
Courtesy of Debbie Dahl, E.EBanner Health
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© 2015 Arizona Telemedicine Program
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© 2015 Arizona Telemedicine Program
Background and Purpose• ResolutionMD mobile application runs on a Smartphone and affords vascular neurologists access to radiological images of patients with stroke from remote sites in the context of a telemedicine evaluation.
• Although reliability studies using this technology have been conducted in a controlled environment, this study is the first to incorporate it into a real‐world hub and spoke telestroke network.
• The study objective was to assess the level of agreement of brain CT scan interpretation in a telestroke network between hub vascular neurologists using ResolutionMD, spoke radiologists using a Picture Archiving and Communications System, and independent adjudicators.
© 2015 Arizona Telemedicine Program
Stroke. 2012; 43:3271‐3277
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Stroke 2012: 43; 3095‐3097
Photograph depicting the bedside National Institutes of Health Stroke Scale (NIHSS) assessment scenario.
Demaerschalk B M et al. Stroke 2012;43:3271-3277
Copyright © American Heart Association
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© 2015 Arizona Telemedicine Program© 2014, Arizona Telemedicine Program
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© 2015 Arizona Telemedicine Program
ResolutionMD mobile infrastructure and algorithm.
Demaerschalk B M et al. Stroke 2012;43:3098-3101
Copyright © American Heart Association
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ResolutionMD mobile.
Demaerschalk B M et al. Stroke 2012;43:3098-3101
Conclusions• Telestroke is cost‐effective (cost‐savings)
• Telestroke by smartphone is possible
Demaerschalk B M et al. Stroke 2012;43:3271-3277
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© 2015 Arizona Telemedicine Program
Major Categories of Services in General Usage
•Gap Services•Urgent Services•Mandated Services
•Direct‐to‐Consumer
© 2015 Arizona Telemedicine Program
“Care Beyond Walls and Wires is the best thing ever for me, and the best
thing for my dad.”
Rita Yazzie
© 2018 Arizona Telemedicine Program
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© 2015 Arizona Telemedicine Program
Tucson Daily StarJanuary 6, 2019
• GET GREAT CARE YOU NEED• Cold & flu symptoms• Allergies• Pink eye• Ear infections• Respiratory infection• Sinus problems• Skin problems• … and more
Massachusetts General Hospital – Department of Pathology – 1960s
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Massachusetts General Hospital – Department of Pathology – 1960s
Massachusetts General Hospital – Department of Pathology – 1960s
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Rashid L. Bashshur, PhD, Ronald S. Weinstein, MD, Jay Sanders, MD
“Pioneers in Telemedicine & Telehealth”American Telemedicine Association
© 2015 Arizona Telemedicine Program
Thank you!
Ronald S. Weinstein, [email protected]