‘Telemedicine’ keeps remote patients linked with care team
By Carole Bartoo
September 24, 2010
On a Friday morning in September, Edwin Davis and his 14-year-old son, Ethan, drove to their family health clinic in Linden, Tenn.
They had an 8 a.m. appointment to see the experts at Vanderbilt's Weight Management Clinic - 90 miles away - and were able to keep the appointment thanks to a live video link from their community clinic.
"We're able to get him back to school faster, and I can get home faster so our family can keep our work schedules. If we went all the way to Vanderbilt, it would have been a five-hour commitment, at least," said Edwin Davis.
Except for the use of telemedicine technology, Ethan's appointment was regular in every other way. He and his father sat in a typical exam room at the Perry County Medical Center and reviewed their concerns. Ethan was recently diagnosed with type 2 diabetes, sleep apnea has been keeping him sleepy at school, and knee pain is beginning to hamper Ethan's style on the basketball court.
Ethan's weight management specialist, Kyle Brothers, M.D., instructor in Pediatrics, listened to father and son through a large video monitor in an exam room at the Monroe Carell Jr. Children's Hospital at Vanderbilt. Brothers told the family that the health concerns are all things that could improve if Ethan successfully manages his weight.
At the end of the hour-long appointment, goals were reviewed and Brothers gave his seat to the clinic's dietitian, who will continue to work with the family through the video-link.
At the end of their appointment, Ethan's father said the video and sound quality was surprisingly good.
He said he prefers to be able to see the face and body language of his providers, and was pleased to be able to see Brothers demonstrating stretches for Ethan to use before basketball practice.
"It's better than phone or e-mail to get emotion and meaning across," the elder Davis said.
The Weight Management Clinic has seen four patients this way, two from Perry County and two from Hardin County, as part of a pilot.
"I think this family would have struggled without this telemedicine link. For families that live as far away as Perry County, getting up at 4 a.m. to get to a doctor's office visit is difficult. We've had families who drove overnight and slept in the parking garage to see us in the morning," said Brothers.
Community Health Network, a non-profit organization, paid for the video and computer set-up as part of the three-year pilot. Vanderbilt is currently testing use of the system to provide telemedicine clinics in pediatric weight management and pediatric diabetes management to patients in rural areas.
"Because Internet services like Skype are not secure, you have to invest in the technology to offer secure communications. This grant with Community Health Network makes it possible. The hope is to expand the telemedicine practice to other parts of the state next year," said Paige Moore, Telemedicine Program Manager.
Moore said the pilot and future plans for the program are based on need, and the need is great in rural areas of Tennessee. Patients like Ethan have an uphill battle since research shows reversing obesity after about age 7 is very difficult. The hope is telemedicine programs like this one may offer another tool to help young people succeed.