Seconds matter. When a critically ill or injured child or patient suffering an ischemic stroke is rushed to an emergency room for care, time is of the essence.
And while emergency room personnel never know exactly what a day may hold in store for them, they want to be ready for any contingency. Sometimes, however, that just might not be possible.
With today’s health care economic realities, most community and rural hospitals can’t afford to have their own dedicated specialists like pediatric critical care intensivists or stroke experts - highly trained doctors who are typically the best qualified and experienced to treat the most critically ill patients.
Today, however, MUSC can put those experts virtually at the bedside of patients throughout the state.
Through the MUSC Health Center for Telehealth, in addition to hospital-based programs, there are several outpatient programs where urgent, primary and specialty care is delivered to patients at virtually any location, even their homes, using MUSC’s mobile health technologies.
Thanks to funding by the South Carolina Legislature, MUSC’s telemedicine program has grown by leaps and bounds, literally putting South Carolina at the forefront of a nationwide trend. Until recently, parts of the program have been housed at various locations across campus, but today, through additional funding from the Legislature, Duke Endowment and private donors, the Telehealth Center now has dedicated space in the main hospital, consolidating its many components, said David McSwain, M.D., a pediatric critical care intensivist and medical director for Telehealth Optimization.
The new Telehealth Center held an open house on June 30 and nearly 70 guests and employees attended the special event, touring the facility and watching live telehealth demonstrations.
McSwain explained the major difference the dedicated center makes for its programs.
“Before now, we had telehealth staff spread out at Rutledge Avenue, Harborview Tower and Institute of Psychiatry, but we were not based where most of our providers were actually providing care. The great thing about the new center is that it centralizes our telehealth activities so we can provide the training, education and support that is needed for our own providers to efficiently practice telehealth. To have everyone here, right in the middle of the action, so to speak, is huge,” he said.
The center is going to be multi-functional in its use, said Adrian Grimes, manager of telehealth external affairs. The learning commons and training center are going to function not only to provide education about telehealth, she said, but also training on the provision of telehealth and real-time support for providers when they are providing telehealth services.
One of McSwain’s responsibilities is to direct the use of the learning commons and training center. Ragan Dubose-Morris, telehealth education manager, will be working with McSwain to deliver innovative and collaborative telehealth training to MUSC providers. Tasia Walsh will continue to assist the team with EPIC integrations.
The Telehealth Center is also the new home for the Admit Transfer Center, which plays a vital role in the efficient delivery of telehealth care.
In addition, the center continues to branch out in many exciting directions and has big plans for growth.
“We are always expanding our services,” McSwain said. “There are several services that we are excited about developing. We’ve learned a lot in the last few years about what works and what doesn’t work and about the factors that contribute to a successful telehealth program. We’re really looking forward to building on those experiences, as we move forward with this new center.”
For one, they are in the early stages of development for a program for medically complex children, collaborating across multiple specialties in the Department of Pediatrics to integrate home telehealth services into a program that focuses on improving the care of children on home mechanical ventilation. The project aims to reduce these children’s length of stay in the hospital, improve their care at home, prevent unnecessary emergency room visits and shorten their time on ventilators.
That program will build on the existing pediatric critical care teleconsultation program, which provides 24/7 availability of pediatric critical care intensivists for consultation to rural emergency departments in South Carolina.
McSwain was one of the presenters at the open house, demonstrating how he can evaluate a sick child remotely and efficiently. The telemedicine program uses cutting-edge equipment to place MUSC’s pediatric specialists virtually at the bedside for children who come into the community emergency department but end up requiring emergent subspecialty consultation.
“We can call into the telemedicine cart within minutes and examine a patient with a high-definition camera that we control from our own location. The stethoscope allows us to listen to heart and lung sounds in real time. It’s like being right there in the patient’s room at the moment you’re most needed, and that is amazing.”
Guests at the open house were amazed at how precise the evaluation was and many were visibly moved by the patient McSwain was evaluating on the huge screen.
Guests were also treated to demonstrations of the telestroke program and school-based telehealth and received a tour of the Tele-ICU control center, which provides 24/7 remote monitoring of patients located in community hospital ICUs across the state.
Another program under development is Continuous Virtual Monitoring, a remote patient monitoring system that’s designed to provide real-time video monitoring and rapid intervention for patients admitted to MUSC medical units or the Institute of Psychiatry with fall risks or other safety issues. These patients currently require a personal sitter in the room with them for their own safety. The new program will allow virtual monitoring technicians to continuously monitor 10 or more patients at a time with the assistance of virtual rails and alerts.
McSwain is also excited about a new program for skilled nursing facilities, which aims to decrease emergency room visits and improve nighttime coverage for nursing home patients, and the growth of home video visits.
“One of the most exciting areas to me is the potential of home telehealth. When you look at the health care landscape and the way telehealth could impact it — the greatest potential is in patients who have chronic illnesses and are heavy utilizers of health care services. To be able to reach into their homes and see them where they live could potentially have a huge impact on their lives and help them in the management of their condition, reduce their utilization of emergency room services, and really impact how they manage their disease. That is a really exciting area we’re working on.”
In terms of the success of the telehealth program and potential of the new center itself, McSwain is optimistic.
“I think the program certainly has grown at a phenomenal pace, and we have the state Legislature to thank for that. They’ve made an amazing investment in telehealth in South Carolina. As a result, we’ve been able to grow telehealth to the point where South Carolina really is on the tip of everyone’s tongue nationally. We’ve taken an innovative approach to health care delivery that is being noticed across the country. But the real goal of the program is to save lives here in our state.”