Flying by Wire and Wireless New Horizons for Telehealth Peter A Pappas MD FACS Vice Chair Dept of Surgery Holmes Regional Medical Center Physician Coordinator Health First Trauma Telemedicine ID: 761715
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Flying by Wire (and Wireless) New Horizons for Telehealth Peter A. Pappas MD FACS Vice Chair, Dept. of Surgery Holmes Regional Medical Center Physician Coordinator, Health First Trauma Telemedicine
“Telemedicine”Utilizing tele-presence for healthcareRapid evolution in a generationInternetComputing power and portabilityWireless evolution/revolutionHD Audio and Video
Transforming Healthcare TodaySPARROWnet®Disaster Management and PreparednessTACTEL®Field Support for First ResponderseMOBILEBringing the ICU to every patient’s bedside
SPARROWNET®Florida’s Emergency Tele-Network
Beginnings 2005-2011Florida Emergency Trauma Tele-networkFlorida Department of HealthU Miami Miller School of Medicine University of Florida College of Medicine Health First/Holmes Regional Goals Develop infrastructure for telemedicine Funding and technical support Connect trauma centers to local hospitals
Responding to DisasterSPARROWnet® - 2012Initiative for disaster managementTraining, education and mutual aid Building on FETTN
SecurePortable A ccessible R edundant R eliable O perational W oven NET work SPARROWnet®
ObjectivesTesting the FETTNSPARROWnet® disaster exercisesVirtual InstructionReal World Activation
Building the NetworkTele-presence connections23 of 25 Florida Trauma Centers“Hub and Spoke” ModelApril, 2012 to June, 2015
SPARROW “Nest” Tele-Presence Hubs FL DOH Health First U Miami
Disaster Management ExercisesFour Exercises Deploying FETTNRadiologic eventHurricane responseBomb, blast and burn Average of five centers per drill Video-enhanced transfers Triage support Specialist expertise
EducationVirtual InstructionDisaster TrainingCritical Care TrainingEmergency ProceduresUM International Tele-Rounds60 Trauma Centers Four Continents
Hurricane Isaac 9/2012First Real World ActivationNine Trauma CentersFlorida Department of HealthFlorida EMS Leadership
SPARROWnet® - Showing the WaySuccessful beginningModel for other states and regionsLeveraging the power of telemedicineOvercome geography to deliver aidEnhance on-site resourcesIntegrated care across distances
SPARROWnet® and the First ResponderNew ChallengesThe Era of the “Active Shooter”High-risk, multiple casualty eventsObjectivesLink medics and trauma centersReal-time support to first respondersEnhance first receiver preparations
TacTel®-Tactical TelemedicinePilot program begun 2011Health First Trauma and Palm BayChief of Police Douglas Muldoon (Ret.) Police Captain John Resh EMT-P District Chief Gaius Hall RN EMT-P
Materials and MethodsTACTEL® equipmentSecure, wireless linkHealth First Telepresence Network4G LTE connectionTablet, hand-held devices Mobile cart at trauma center
ResultsEvaluation June, 2011 to April, 2013Four SWAT training exercises18 patient scenariosGunshot wound to the torsoHead injury Extremity bleeding
2013 Alliance for Innovation Award
Trauma Surgeon as Virtual ParticipantReal-time interaction with the fieldTourniquet applicationNeck and spine stabilizationTechniques for respiratory assistanceProvide expertiseGet the facts on a patient in real-time
From the Field to the Bedside….
eICU Supported Rapid Response Teams
The Beginning2003 – Rapid Response TeamsInstitute for Healthcare Improvement (IHI)Evaluate patients who suddenly deteriorateHealth First Rapid Response TeamsICU NurseRespiratory TherapistPhysician (Primary or Hospitalist)
VitalWatch®2004 Health First establishes Vital Watch® First eICU in the Southeastern USMonitoring of all Health First hospital Intensive Care Units50,000 Patient interactions a year in 2014VitalWatch – an entire ICU teamCritical Care Physician Critical Care Nurses Pharmacist Health Unit Coordinator
Trauma Telemedicine2011 -Florida Emergency Trauma NetworkGrant funding to Holmes Regional TraumaSecure servers, software and wireless mobile cartsSPARROWnet® and TACTEL®Health First centered initiativeLinking Florida Trauma CentersTraining, Education, Disaster Management
Great programs with great results, but…
What Can we do Together? VitalWatch + Trauma Telemed + RRT Nursing.advanceweb.com VitalWatch Holmes Regional Trauma Center
Health First eMobile ProgramBedside RRT Support by TelemedicineConnected to VitalWatchAll four Health First hospitalsWireless Mobile CartsSecure HIPAA Compliant Network
The Instrument: eMobile Cart
Today…Over 800 eMobile activations since January, 2012Supporting bedside providersTriaging patients for appropriate level of careIdentifying Stroke, Cardiac and Sepsis Alerts
Publication and AwardsJournal of Telemedicine and e-HealthProjecting Critical Care Beyond the ICU: An Analysis of Tele-ICU Support for Rapid Response TeamsPappas PA, Tirelli L, Shaffer J, Gettings S Florida TeleHealth SummitFirst Place Poster
Published DataJanuary, 2012 through September, 2014567 eMobile activations with a 99% call completion rate34% of patients managed without ICU transfer59% transferred to the ICU 7% transfer to a progressive care unit (PCU)
Providing Quality CareNo adverse events related to eMobile careeMobile vs Bedside Doc RRT FY 2014No significant difference in transfer rateseICU MD equivalent to on-site MD RRT Support Call Volume Transfer ICU% Transfer PCU% Remain Floor% eMobile 244 53 9 36 Traditional 659 4812 34
An Effective Example of TelemedicineeMobile is a powerful means of delivering careTele-ICUs like VitalWatch® are an ideal foundation to develop similar mobile platformsVictory for Synergy– utilizing the diverse tools and talents of our organization
A New Road for the FutureStrengthen communication between healthcare professionals and their patientsNew era in emergency communication as revolutionary as the CB radio
Where Does that Road Lead?
Leveraging Tele-presenceConnecting the Dots as Never Before Field Medical Support
A final note…“No one need ever again be lost, for a simple position-and-direction finding device could be incorporated into a (telephone) receiver…And in case of danger or accident, help could be summoned merely by pressing an ”Emergency” button. …activity…can be carried out over radio circuits. The time will come when surgeons will be able to operate…away from their patients…and every hospital will be able to call on the services of the best specialists, wherever they may be… Arthur C. Clarke – “Profiles of the Future” 1962
For More InformationPeter A. Pappas MD FACSsparrownetfl@gmail.com©2013,2016 Peter Pappas MD. These materials are owned by Peter Pappas MD FACS, and may not be used, copied, or distributed except under written license from the owner
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