the lvhn teleburn program

The LVHN TeleBurnSM Program

Mid-Atlantic Telehealth Resource

Center Summit

March 15-16, 2012

Joe Tracy

VP – Telehealth Services

Program Purpose

■ To assess burn patients quickly by both the local Emergency Room attending physician and an LVH Burn Surgeon.

– Initiate treatment earlier!

– Triage Enhancement through Collaboration with a Regional Burn Center.

What is so innovative about

LVHN TeleBurnSM?

■ Outreach strategy involving:

– A service not typically offered by many small hospitals.

– Visits and presentations to remote sites by:

• Burn Center Medical Director

• VP of Telehealth

• TeleBurn Liaison (on-going sales and service)

– Information Services providing the technology support.

What is so innovative about

LVHN TeleBurnSM?

■ Outreach strategy involving:

– Simple and inexpensive technology for the remote site.

– Agreements between LVHN and the sites.

– The Guide to Getting Started with LVHN TeleBurn.

– 24/7/365 response by LVHN Burn Surgeons

– mHealth technologies used at LVHN

Back to the Future

Emergency Telephone Call – Burn

Remote Physician Description

■ 83 year-old male

■ Burned his lower leg yesterday while burning brush with gasoline.

■ His burn looks to be about 0.5% TBSA.

■ Wound is pink and moist with blistering.

■ Patient has a history of diabetes and heart disease as well as mild dementia.

■ I would like to treat him here and refer if there are any complications with healing.

Additional Conversation

■ Burn Surgeon: Is his pain controlled and

does there appear to be any signs or

symptoms of cellulitis.

■ Remote Dr.: His pain is controlled and he

does not have any signs of cellulitis. His

wound looks pink.

■ Burn Surgeon: Does the wound blanch?

■ Remote Dr.: It appears to blanch in the

area of blister…..

Do you have the image of this burn

in your mind?

Case Summary

■ TELEPHONE – Same verbal

communication – No Visual – .5% burn TBSA – Pt. probably treated

local and sent home. – Big chance for

infection – If wound becomes

infected – two surgeries vs. one

■ TELEHEALTH – Same verbal

communication – Couple Digital Pics – 1.5% burn TBSA – Pt. transferred to

LVHN Burn Center – No infection due to

timely treatment – One surgery – next

day – discharged on day 5

Important Points to Make Based

on the Summary

■ Telehealth provides a better assessment of

the patient, because providers are not

working blindly.

■ Payor implications – two surgeries vs. one

and corresponding LOS differences.

■ Think about the legal issues of

mistreatment.

■ MOST IMPORTANT – think about the

implications for the patient.

LVHN TeleBurn by the Numbers (December 2008 – Current)

■ Hospitals

– 37 installed

– 7 pending installation

– 10 pending agreements

– 4 contacted

– 8 on the radar screen

■ Industry partners

– HealthWorks

– Just Born

– Deka Batteries

TeleBurn Encounters To Date

(December 31, 2011)

38%

36%

15%

11%

Admitted to BC

Outpatient BC Only

Remained Local

Other

N = 1132 patients

TeleBurn Encounters by Month

0

10

20

30

40

50

60

70

Jul

Aug

Sep Oct

Nov

Dec

Jan

Feb Mar

Apr

May Ju

n

FY 2011 FY 2012

Declining Cost to Implement

TeleBurn

■ 2008 TeleBurn – Version 1 - ~$5,000

■ 2009 TeleBurn – Version 2 - ~$2,400

■ 2009 TeleBurn – Version 3 - ~$400

Too Cumbersome!

LVHN TeleBurnSM

Make Sure You See

The Entire Picture!

Picture – courtesy of Robert Schosser, MD, East Carolina University

Accurate Verbal Description, but

the Picture Tells the Story

Picture – courtesy of Robert Schosser, MD, East Carolina University

Summary

■ Enhanced communications by adding a couple pictures to the conversation.

■ Implemented a web-based, mHealth solution to speed up the emergent conversation.

■ Built a solid outreach program around the program.

■ Provide on-going support to the TeleBurn sites!

Questions & Answers

My Contact Information:

Joe Tracy

Vice President – TeleHealth Services

(484) 884-8633

joseph.tracy@lvhn.org