May K. Toney
06-25-2003, 07:11 PM
NEED A BREAK FROM PI TALK?
I've never worked directly in the field of medicine but I've always admired those that do. The Medical channel simply fascinates me and I'm thankful to all the research and new discoveries that come to us through the diligence of others. It's also one of the few shows I watch regularly.
I auto program live surgical procedures and remain glued to the screen for hours watching each one. It's no wonder that I found the Virtual Doctor and Patient story interesting. If the story does nothing else, it might give you a break from PI issues. Or, you might ask yourself what in the world will specialists charge for a virtual vs actual doctor visit? Otherwise, you'll just learn more than you ever wanted to know about the cause and treatment of strokes.
VIRTUAL DOCTOR AND PATIENT
New Technology Facilitates Treatment By Remote
Chicago Tribune, Sunday 6/22/03 ed.
-Maria Kantzavelos
For a neurologist, time is of the essence when it comes to diagnosing and treating stroke. The longer it takes to treat a patient showing signs of stroke, the more debilitating the effects can be.
But not all hospitals have ready access to neurologists, or physicians with comprehensive training and expertise in stroke. Less than half of the hospitals outside the greater Chicago metropolitan area and its surrounding counties have a neurologist on staff, according to Dr Sean Ruland, Director of Neurologic Critical Care at Rush-Presbyterian St Luke's Medical Center.
That's why neurologists, together with emergency medicine physicians at Rush, are testing a telemedicine system that can bring a neurologist and a patient together in a matter of minutes, no matter where they are.
The system, known as TeleStroke , uses television monitors and Web camera equipment to connect physicians in remote areas with patients they couldn't normally reach quickly. Using a two-way videoconferencing system via computers, the program links the stroke specialist from a remote location with the patient and emergency department staff in the hospital. The specialist can then evaluate the patient, view the patient's brain scans and diagnose the type of stroke so that emergency medicine physicians can administer the appropriate medication and treatment.
Ruland said the program is being tested in the emergency department at Rush in simulated stroke situations, and soon will be used on actual patients. Eventually, Ruland said, the program might be offered to other hospitals affiliated with Rush, and to hospitals in rural and non-urban areas of Illinois that do not have ready access to neurologists.
Stroke is the third leading cause of death in the United States. Most strokes occur when a blood vessel to the brain is blocked and blood flow ceases to an area of the brain. A clot-dissolving drug known as tissue plasminogen activator, or t-PA, restores blood flow to the brain and has been shown to reduce the effects of stroke. Stroke experts can determine if a patient should be treated with the drug, which must be administered within 3 hours after stroke symptoms begin.
"The purpose of doing this (implementing the TeleStroke program) is to be able to increase patient access to the neurological expertise," Roland said. "In the case of an acute stroke you've only got a very small 3-hour window in which to work. The earlier you get treated within the 3 hours the greater the benefits. It's just one other way to decrease that time span. They don't have to wait for me to drive in."
Although the stroke specialist on the remote end cannot touch the patient, he or she can perform a neurological examination with the help of the system and emergency room personnel on the other end. With Web cameras on both ends, the neurologist can see the patient and the patient can see the neurologist.
"I may be asking the patient to perform different tasks," said Ruland, explaining his approach to an examination via TeleStroke. "I'll look at the very way the eyes move, how the patient processes information, I'll look at the symmetry of the musculature, the droopiness of the face - all the things that are highly visual. I get control of the camera from the remote end. If I wish to look at eye movements I can zoom the camera and get nothing but your eyes."
Physicians at Rush said the system would be beneficial in times when their own neurologists or consultants are not available during an emergency situation involving a patient showing signs of a stroke.
When a patient is admitted into the emergency room with symptoms of stroke, an ER physician would page the on-call neurologist, said Dr Dino Rumoro, Clinical Chairman of the Department of Emergency Medicine at Rush. "If he's not on site, we roll it (the TeleStroke system) out of our office, put it at the foot of the patient's bed, plug the telephone line in and turn it on. What the patient sees is the image of the physician on the television screen. On top of the television unit is a camera eye. The neurologist sees the patient through that camera eye. The patient is actually seeing a physician on the television and can hear him talk," Rumoro said.
The TeleStroke system is in operation at other hospitals in the country, including Massachusetts General Hospital, and the University of Maryland Medical Center.
Rush's Rumoro said he could see the system being used for other emergency medicine diagnostics, especially in cases involving potentially infectious diseases in which patients present themselves with rare rashes, and in complicated hand injuries that require emergency surgery.
"There certainly is no substitute for being there at the bedside, but if it's not possible this certainly adds the element for patient interaction," Ruland said. "If it weren't for this type of equipment I would hear a story over the telephone. I might ask questions about the patient's vital signs and CAT scan image, but I wouldn't be able to see it. With TeleStroke I get to see the patient."
I've never worked directly in the field of medicine but I've always admired those that do. The Medical channel simply fascinates me and I'm thankful to all the research and new discoveries that come to us through the diligence of others. It's also one of the few shows I watch regularly.
I auto program live surgical procedures and remain glued to the screen for hours watching each one. It's no wonder that I found the Virtual Doctor and Patient story interesting. If the story does nothing else, it might give you a break from PI issues. Or, you might ask yourself what in the world will specialists charge for a virtual vs actual doctor visit? Otherwise, you'll just learn more than you ever wanted to know about the cause and treatment of strokes.
VIRTUAL DOCTOR AND PATIENT
New Technology Facilitates Treatment By Remote
Chicago Tribune, Sunday 6/22/03 ed.
-Maria Kantzavelos
For a neurologist, time is of the essence when it comes to diagnosing and treating stroke. The longer it takes to treat a patient showing signs of stroke, the more debilitating the effects can be.
But not all hospitals have ready access to neurologists, or physicians with comprehensive training and expertise in stroke. Less than half of the hospitals outside the greater Chicago metropolitan area and its surrounding counties have a neurologist on staff, according to Dr Sean Ruland, Director of Neurologic Critical Care at Rush-Presbyterian St Luke's Medical Center.
That's why neurologists, together with emergency medicine physicians at Rush, are testing a telemedicine system that can bring a neurologist and a patient together in a matter of minutes, no matter where they are.
The system, known as TeleStroke , uses television monitors and Web camera equipment to connect physicians in remote areas with patients they couldn't normally reach quickly. Using a two-way videoconferencing system via computers, the program links the stroke specialist from a remote location with the patient and emergency department staff in the hospital. The specialist can then evaluate the patient, view the patient's brain scans and diagnose the type of stroke so that emergency medicine physicians can administer the appropriate medication and treatment.
Ruland said the program is being tested in the emergency department at Rush in simulated stroke situations, and soon will be used on actual patients. Eventually, Ruland said, the program might be offered to other hospitals affiliated with Rush, and to hospitals in rural and non-urban areas of Illinois that do not have ready access to neurologists.
Stroke is the third leading cause of death in the United States. Most strokes occur when a blood vessel to the brain is blocked and blood flow ceases to an area of the brain. A clot-dissolving drug known as tissue plasminogen activator, or t-PA, restores blood flow to the brain and has been shown to reduce the effects of stroke. Stroke experts can determine if a patient should be treated with the drug, which must be administered within 3 hours after stroke symptoms begin.
"The purpose of doing this (implementing the TeleStroke program) is to be able to increase patient access to the neurological expertise," Roland said. "In the case of an acute stroke you've only got a very small 3-hour window in which to work. The earlier you get treated within the 3 hours the greater the benefits. It's just one other way to decrease that time span. They don't have to wait for me to drive in."
Although the stroke specialist on the remote end cannot touch the patient, he or she can perform a neurological examination with the help of the system and emergency room personnel on the other end. With Web cameras on both ends, the neurologist can see the patient and the patient can see the neurologist.
"I may be asking the patient to perform different tasks," said Ruland, explaining his approach to an examination via TeleStroke. "I'll look at the very way the eyes move, how the patient processes information, I'll look at the symmetry of the musculature, the droopiness of the face - all the things that are highly visual. I get control of the camera from the remote end. If I wish to look at eye movements I can zoom the camera and get nothing but your eyes."
Physicians at Rush said the system would be beneficial in times when their own neurologists or consultants are not available during an emergency situation involving a patient showing signs of a stroke.
When a patient is admitted into the emergency room with symptoms of stroke, an ER physician would page the on-call neurologist, said Dr Dino Rumoro, Clinical Chairman of the Department of Emergency Medicine at Rush. "If he's not on site, we roll it (the TeleStroke system) out of our office, put it at the foot of the patient's bed, plug the telephone line in and turn it on. What the patient sees is the image of the physician on the television screen. On top of the television unit is a camera eye. The neurologist sees the patient through that camera eye. The patient is actually seeing a physician on the television and can hear him talk," Rumoro said.
The TeleStroke system is in operation at other hospitals in the country, including Massachusetts General Hospital, and the University of Maryland Medical Center.
Rush's Rumoro said he could see the system being used for other emergency medicine diagnostics, especially in cases involving potentially infectious diseases in which patients present themselves with rare rashes, and in complicated hand injuries that require emergency surgery.
"There certainly is no substitute for being there at the bedside, but if it's not possible this certainly adds the element for patient interaction," Ruland said. "If it weren't for this type of equipment I would hear a story over the telephone. I might ask questions about the patient's vital signs and CAT scan image, but I wouldn't be able to see it. With TeleStroke I get to see the patient."