Ryan was one of the sickest patients I had managed in years. Pneumonia was robbing his bloodstream of oxygen, and I was sure I would have to send him to Portland for specialized care.
But that didn’t happen. Instead, interactive video technology allowed doctors from OHSU Doernbecher Children’s Hospital to consult on Ryan’s case from a distance. He made a full recovery at Bay Area Hospital, without the expense and family disruption of traveling to Portland.
A healthy 8-year-old, Ryan had been sick for a week with fever and cough when I first examined him. Pneumonia had infected both lungs. Ryan’s oxygen level was so low; he needed to be hospitalized to receive extra oxygen and additional treatments.
After being admitted to a Bay Area Hospital, Ryan deteriorated further. His breathing became more labored and rapid, and he needed even more oxygen. We decided to obtain a telemedicine consultation with Doernbecher’s pediatric intensive care specialists. Like Skype on steroids, telemedicine offers ultra-high definition video conferencing. An OHSU PICU doctor can position the robotic camera as needed, zooming in and out to examine a patient in Coos Bay.
Dr. Laura Ibsen was the first pediatric intensivist to examine Ryan from afar. Using interactive live video, she could direct questions to Ryan’s parents and view the child’s vitals and lab results in real time. Ryan’s mother, Michelle, thought it was fantastic. Dr. Ibsen offered us a small suggestion, along with reassurance that we could keep Ryan at Bay Area Hospital. The next day, however, a new chest X-ray looked much worse. We again turned to telemedicine, consulting OHSU Doernbecher’s Dr. Miles Ellenby.
Dr. Ellenby affirmed our treatment of Ryan and stayed in contact with us throughout the day. Dr. Ellenby’s confidence in us and his suggestions made a big difference to our efforts. Ryan began showing sustained improvement. His family was relieved. “It was reassuring to know there was not a better option,” his mother, Michelle, said. “Everything was being done appropriately.”
Several days later, no longer needing supplemental oxygen or IV medications, Ryan went home!
Telemedicine helps us in many ways:
1. It improves patient care. Our community has eight well-trained pediatricians, but we spend most of our time in the office seeing mild illness. Thanks to modern vaccines, we use our hospital skills much less than in the past. Having a specialist co-manage our patients keeps us up to date.
2. It improves patient safety. We have consulted OHSU physicians while caring for critically ill patients. Not only did they provide extra knowledge, they helped focus on the basics, such as CPR and proper placement of endotracheal tubes.
3. It bolsters staff confidence. Nurses are more confident when they are part of the consultation with OHSU.
4. Families can stay together. Ryan’s sister was also sick, but she did not have to be in the hospital. If Ryan had been sent to OHSU, the family would have struggled to find childcare for his siblings.
5. We save money and resources. A transport from Coos Bay to Portland might cost as much as $30,000 – not including the cost of the stay at OHSU. Also, eliminating the trip means the highly trained pediatric ICU nurses and respiratory therapists on OHSU’s transport team can stay in Portland, caring for other patients.
Telemedicine is the best of both worlds. Patients have access to some of the best specialists in the country while staying in their community hospital, with their own provider.
Jon Yost, M.D., F.A.A.P. was raised in Bandon, Ore., and earned his medical degree from OHSU. He received his pediatrics training at Children’s National Medical Center in Washington, D.C., and has been treating patients at Bay Clinic since 2003.