June 19, 2014

Teleneurology services at Williamson Medical Center see success

A new telemedicine partnership between Vanderbilt University Medical Center (VUMC) and Williamson Medical Center (WMC) is allowing more patients with acute neurological conditions to stay in their community.

Eight VUMC neurologists are on call 24 hours a day to provide remote consultations for patients at WMC with urgent neurological conditions, such as stroke, seizure or severe headache. Since its inception in February, more than 100 patients have been seen through the service, with 85 percent able to stay at WMC and 15 percent transported to VUMC.

“The majority of patients stay at their home hospital, which is what they want. They know the doctors there, have their support system nearby and are more comfortable there,” said Lisa Hermann, M.D., assistant professor of Neurology and director of Teleneurology.

“But they also know they are receiving the same expert care from Vanderbilt neurologists that they would receive on our main campus, and patients who would benefit from higher-level care can be transported to Vanderbilt.”

“It has been a distinct pleasure to work with the Vanderbilt neurologists in developing the teleneurology program that we now have at WMC,” said Starling C. Evins, M.D., chief medical officer at WMC.

“After months of planning, the program is running well now; although we are continually trying to fine tune it. This is Vanderbilt’s and Williamson Medical Center’s first venture into telemedicine to provide high quality care to patients in the Vanderbilt-affiliated hospitals—care which otherwise would require a transfer to VUMC. We are hoping to explore other areas of telemedicine in the future.”

This teleneurology partnership is one facet of an overall goal to bring a higher level of subspecialty care to hospitals in the Vanderbilt Health Affiliated Network.

“As thousands throughout the Southeast look to Vanderbilt for their health, we must deliver the highest level of specialty care to our patients in partnership with our community-based affiliate hospitals, clinics and physicians. Telemedicine is one key step to successfully realizing this goal,” said Robert Macdonald, M.D., Ph.D., professor and chair of the Department of Neurology.

Hermann said that this partnership, which averages one to three consults per day, is an answer to a national shortage of neurologists.

“There are not nearly enough neurologists to deliver inpatient care,” she said. “This is a very important investment Vanderbilt is making. This is the future of subspecialty care in rural areas. We have to decrease costs but deliver excellent care, and this is a viable way to do that.”

VUMC providers receive a page when a consult is requested, and respond within 10-15 minutes. They discuss the patient’s symptoms, medical history and medications with the WMC provider, and can access the patient’s tests and scans virtually. They can also examine the patient via videoconferencing.

“We have a great working relationship with the physicians at WMC, and they are truly outstanding. It’s a privilege to team up with them,” Hermann said.

“Overall, this has great savings to the health care system and provides patients with subspecialty care in their community so that they can remain near their homes and family.”

The partnership also has the benefit of saving time, which is especially crucial for stroke patients.

“We have assisted WMC physicians in providing tPA (the clot-busting drug), and the time from stroke onset to treatment is very quick. Ambulances used to bypass Williamson when they had a stroke patient, but now they can stop there and receive treatment much sooner,” Hermann said.