CHIPLEY — Northwest Florida Community Hospital is teaming up with Gulf Coast Medical Center to offer area stroke victims a faster treatment option through the use of telemedicine and robots.
Andy Long, director of neuroscience and telehealth services with Gulf Coast Medical Center in Panama City, and Daniel Dunlap, hospital outreach director with Hospital Corporation of America in Tallahassee, met with the NFCH Board of Directors on Oct. 15 to explain the program, which will allow neurologists in Panama City to interact with and treat stroke victims brought to the Chipley hospital.
“There isn’t any where in the stretch along Interstate 10 from Tallahassee to Pensacola that offers stroke care,” Dunlap told the board, “which means stroke victims from Jackson, Holmes or Washington Counties have to be taken to Panama City, a 50-minute trip.”
The treatment of strokes is very time sensitive, with brain function lost by the minute during the attack. The sooner a patient can get seen by a neurologist and prescribed the clot-busting drugs called thrombolytics needed to treat strokes, the better the patient outcome will be, Dunlap explained.
Despite the effectiveness of the thrombolytics, many patients are not treated due to late arrival at the emergency room, a delay in assessment or administration of the drug, Long said. According to a 2012 article, on 41.7 percent of stroke patients had brain imaging within 25 minutes of their arrival for treatment.
“Stroke is the leading cause of disability in adults, and every 4 minutes someone dies of a stroke,” Long said. “Strokes can and do occur at any age, and nearly one quarter of strokes occur in patients under the age of 65.”
Currently, Gulf Coast Medical Center is the nearest facility with Joint Commission Disease Specific Certification in Primary Stroke care. Through the Hospital Corporation of America Telemedicine Initiative, which will allow the neurology staff of GCMC to treat patients in Chipley using cloud-based internet technology, patients from the tri-county area can be brought to the ER at Northwest Florida Community Hospital and begin receiving their treatment much sooner.
Hospital Corporation of America is the country’s largest non-governmental healthcare system with 162 hospitals and 113 ambulatory surgery centers. HCA is also the parent company of Gulf Coast Medical Center.
HCA facilities are responsible for 4 to 5 percent of all inpatient care delivered in the US today, Long said, and has operations in 20 states and England with about 199,000 employees.
The North Florida Division of HCA has 16 hospitals in North Florida and south Georgia, five ambulatory surgery centers, seven urgent care locations, two free-standing emergency departments, five radiology oncology centers, four diagnostic imaging centers as well as more than 50 physician practice locations and 19,000 employees.
The HCA Telemedicine Initiative will allow 24/7 access to neurology and neurosurgery coverage and will increase the volume of care delivered locally, Long said.
The telemedicine network is also being offered to NFCH at no charge, Long said. “The purpose of the program is to not only save money for the hospitals participating, but to ultimately lower the cost of health care.”
“The goal of the HCA Telemedicine Initiative is to develop a regional network that increases the ability of specialized physicians to consult, triage and diagnosis critically ill neurological patients in under served areas,” Long said, “by leveraging the technology of telemedicine to keep patients close to home when possible.”
The telemedicine network is administered by InTouch Health, Long said.
InTouch Health offers the industry's only complete end-to-end products and service solution specifically designed to facilitate improvements in patient care and increase hospital revenue in acute care settings, according to the company website, intouchhealth.com.
Long said InTouch Health’s experience provides the insight required to overcome the technical, program and implementation challenges faced when creating a telemedicine program, and the company has a track record in creating sustainable programs for customers.
The robots which are used feature screens on which the patient sees the consulting doctor and the doctor sees the patient at their end of the computer. The robots come in different formats, and they are able to access data directly from the patient, even being able to “listen” to a stethoscope, Long said.
The model of robot NFCH may receive is called RP-Lite. The robot “provides a convenient, cost-effective moveable platform for delivering state-of-the-art remote presence capabilities across a broad array of locations supported by InTouch Health's comprehensive connective services and support,” according to the InTouch website.
Features of the RP-Lite include a Pan-Tilt-Zoom camera system that optimizes viewing of patients and others; immersive, directional audio modes improve clarity in hospital settings; dual-purpose workstation can be used for data entry while physicians are logged on; and accessories include a stethoscope kit, privacy headset and composite video port.
The RP-Lite looks like a flat screen TV attached to a portable X-ray machine stand. The RP-VITA robot, however, another of the InTouch telemedicine robots, looks like something from Star Wars and has autodrive capabilities that allow it to safely navigate and travel to selected destinations without requiring user guidance.
The telemedicine network is cloud based and run on a fiberoptic networks, Long said. According to the InTouch website, The SureCONNECT program maintains reliable connections and is secure. The program has FDA clearance and meets HIPAA compliance requirements.
“The system also pings your robot every two minutes to make sure it is functioning,” Long said. “There is no use in having this technology if the batteries go dead or it isn’t working when you need it.”
Dunlap said it will take about 60 days to get the telemedicine system online and get the training completed for the NFCH staff.
“We should be up and running by the end of the year,” Dunlap said.
One of the most important aspects of the program will be educating the public and the area Emergency Medical Services about the stroke telemedicine program so they know to bring patients to NFCH for treatment.
The acronym FAST is used in educating the public on the symptoms of a stroke. FAST stands for Facial drooping, Arm weaknes, Slurred speech, and Time — time to call 911.
“Educating the public is a key factor,” Long said. “Too often, people will just go lay down, thinking they are going to feel better, but then it is too late.”