Accessing specialized medical care can be challenging for patients living outside large metropolitan areas, which is why Peterson Regional Medical Center invested in technology that allows patients to see hard-to-find specialists without ever leaving the Texas Hill Country.
Peterson Health has three telemedicine carts — one in the emergency department, another rotating as needed throughout the 124-bed hospital and the third stationed at the ambulatory care center. “Thanks to advanced IT technology and the service that we get from HCTC, this is just an added benefit that we are able to provide this to patients and keep their care close to home,” says Lisa Winters, Peterson’s director of marketing and community relations.
ALWAYS ON CALL
The carts, also called robots, consist of large monitors on mobile stands that providers can wheel into patients’ rooms. The physicians who appear on the screen are available through a partnership between Peterson Health and Dallas-based Access Physicians, and nurses are in the room to assist as needed.
“The technology is clear enough that the physician, via the monitor, can manipulate a camera so that he or she can zoom in on a patient’s wounds or whatever they’re trying to look at,” says Kelli Griffith, assistant pharmacy director. “There’s a stethoscope that’s available that the nurse can use so that they can pull vitals. It’s very much like they’re at the bedside and can see and hear those things for themselves.”
The robots in the hospital and ambulatory care center help with infectious disease cases, whereas the robot in the emergency department is for patients who need neurology and psychiatric care, called teleneuro and telepsych. “It’s available when they need it,” Griffith says. “We have neurologists, and we have staff here in Kerrville, but when they’re unavailable, that’s when we staff with telestroke. For a patient who might present having a stroke, we have immediate access to the neurologist.”
The robots have been used in infectious disease cases since last June, with service available for hospital patients seven days a week from 7 a.m. to 5 p.m. and at a monthly wound care clinic for outpatients. “They’re able to provide a more specialized look at some of the things that we see here at Peterson, such as bone infections that we might have or abscesses that are difficult to heal or an off-the-wall pathogen or bug that’s difficult to treat,” says Pam Burton, infection prevention registered nurse.
“They actually are here to assist in the treatment of our patients, but another added benefit of that is that the patients don’t have to travel to San Antonio for a lot of their treatments,” Burton says. “That prevents a lot of traveling for the majority of our population, which eases the burden on them and also will help their healing process.”
Infectious disease physicians are increasingly hard to come by. Fewer doctors are choosing the specialty, and many who do are focusing their practices on treating HIV in large cities. Having the availability of these physicians every day is a great benefit to Peterson patients.
“It also ensures we are treating the patient appropriately for whatever infectious process they may have going on that might be difficult to manage, like, ‘Are we giving the right drug at the right dose for the right duration?’” Burton says. “So many factors come in to medication administration, and if we underdose we can run into problems and not treat correctly. If we overdose we can run into problems and potentially cause the patient further harm or potentially an extended period of stay.”
Patients have received the robots well, and Burton says they are very well-educated about how the process works. “The patients have reacted very positively, in part because these physicians are trained on how to look on camera, what the background needs to look like, how to share that empathy through a screen, how to look at the patient and give it that personal touch,” Griffith adds. “They can look through their own computer and directly at that patient, so they’re not looking away at their computer and trying to type at the same time.”
Telemedicine patients are also spared the hassle and expense of traveling long distances for a traditional doctor’s appointment. “We’re rural out here, so Peterson Health treats a lot of these little communities,” Burton says. “To save them that time and travel, it’s a cost benefit to them, as well. Our population is more the retired population, so to provide them with this convenience is great.”
BROADBAND MAKES IT ALL POSSIBLE
None of the benefits of Peterson’s telemedicine services would be possible without a strong and reliable broadband connection like the one HCTC provides.
“Without an internet connection, this wouldn’t be possible. We just wouldn’t be able to provide the service at all,” Griffith says. “The broadband service that is provided to us has been, in my experience, an exceptional connection, clear and easy to see and hear the person on the other side. It is truly like the physician is in the room, and it’s all because of that wireless service.”