EASTON — The Eastern Shore is bound by the Chesapeake Bay to the west, separated from the urban hubs of Baltimore and Washington, D.C.
For the University of Maryland Medical System and UM Shore Regional Health, bridging the Chesapeake Bay is a priority, especially for critically ill patients who need access to medical specialists. UM Shore Regional Health has developed ways to bring treatments to many Shore patients without forcing them to make the trip to downtown Baltimore for specialized care.
Telemedicine, defined broadly as the use of telecommunication and information technology to provide clinical health care from a distance, has enabled patients and health care systems to overcome distance barriers and provide access to medical services that often would not be available in rural communities like those on the Eastern Shore.
Shore Regional Health introduced telemedicine in 2014 for intensive care units at UM Shore Medical Centers at Chestertown, Dorchester and Easton. University of Maryland Medical Center’s (UMMC’s) cutting-edge 24/7 tele-ICU service provides patients, physicians and nurses access to UMMC intensivists — physicians specializing in intensive care medicine — during overnight hours for assistance in caring for ICU patients. Based in the UMMC intensive care unit, the tele-ICU providers complement Shore Regional Health’s intensivists.
The tele-ICU technology includes a special camera in all ICU rooms, along with continuous patient information data feeds to monitor vital signs. An alert in each room allows local ICU staff to request specific tele-ICU assistance.
“The technology gives us direct contact with the UMMS and University of Maryland School of Medicine specialists around the clock,” said Shore Regional Health’s Chief Medical Officer, Dr. William Huffner. “Our ICU patients have the advantage of prompt, expert attention 24 hours a day. Telemedicine technology allows patients to stay close to home and have immediate access to specialists, even after hours.”
Shore Regional Health received a $75,000 grant in 2017 from the Maryland Health Care Commission (MHCC) to extend behavioral health assessments and palliative care consults for families in Kent and Queen Anne’s counties via telemedicine. The grant supported the purchase of telemedicine technologies and training for clinicians and support for researchers. “Shore Regional Health is very fortunate to have highly qualified physicians and advanced practice professionals in both palliative care and psychiatry,” Huffner said. “However, the size of our region — five counties covering more than 2,200 square miles — made it impossible to offer on-site care by these specialists at all locations, at all times.”
In palliative care, telemedicine facilitates the doctor or other care provider’s conversations with patients regarding their goals, adjustments to the care plan and the possible need for advance care planning. In many cases, family members are present with the patient and can participate; if they can’t be there in person, they may participate through their own computers from anywhere in the world.
A study completed last summer indicated excellent success for the use of telemedicine in both emergency psychiatric care and palliative care. In emergency psychiatric care, wait times and transportation for patients needing assessment in Kent and Queen Anne’s counties were reduced by nearly one-third. In palliative care, telemedicine facilitated a threefold increase in the number of patients and their families who were able to access and benefit from a palliative care consult and/or treatment.
Shore Regional Health’s Regional Medical Director of Emergency Medicine, Dr. Walter Atha, said before telemedicine was implemented, patients needing a behavioral health assessment would lose hours being transported between facilities.
“Telemedicine allows us to extend our resources and better serve our patients,” Atha said. “The patients respond very favorably to the technology. Talking with someone remotely through a screen is new at first, but the technology provides no delays in the video. Everything is crisp and instantaneous. No pixelation or delays.”
DocHalo, a program than enables the secure sending of images and patient data for other medical personnel to view is another way telehealth technology has helped patients on the Mid-Shore.
“If someone has an injury or abnormality, a photo can be taken and sent to a specialist for review rather than the patient having to travel to the specialist,” Atha said. “The DocHalo network is secure, so the patient’s privacy is protected.”
Huffner said patients’ electrocardiograms (EKG) also can be sent from an outside location by paramedics to the emergency room in real time, ahead of a patient’s arrival to the Emergency Department.
“The physicians and staff at Shore Regional Health can prepare for an incoming patient based on what the EKG says,” Huffner said. “The minutes saved are valuable in saving lives and reducing morbidity.”
Huffner said Shore Regional Health is always looking at ways of expanding telemedicine’s benefits to its patients. Currently, SRH has telehealth capabilities in psychiatry, behavioral health, pediatric emergency medicine, emergency medicine physician triage, critical care, palliative care, stroke care and pharmacist assisted medication reconciliation. The hospital system is working toward developing telemedicine capabilities for neurology, child psychiatry, dermatology and primary care.
For more information about University of Maryland Shore Regional Health or to find a health care provider, please visit www.umshoreregional.org.