The infant’s X-ray results were troubling. He appeared to have a pneumothorax—a large collection of air trapped between his lungs and chest wall that was making it difficult for him to breathe. Treating it would require his transfer from Sacred Heart Medical Center in Eugene to the Pediatric Intensive Care Unit (PICU) at OHSU Doernbecher Children’s Hospital.
The child’s pediatrician, notified of the results, immediately requested a telemedicine consultation with OHSU, remembers Thomas Roe, M.D. ’61, medical director of Sacred Heart’s Telemedicine Program.
A two-way audio-video communications cart was rolled to the child’s bedside, and within minutes, an OHSU Doernbecher pediatric intensivist was examining—virtually—the six-week-old infant. The OHSU physician concluded there was no clinically significant pneumothorax. A follow-up X-ray confirmed it. The child was able to stay in Eugene and recover close to home.
That telemedicine consultation in 2007 was part of a high-tech revolution in Oregon’s health care delivery, ushered in with the help of physicians such as Dr. Roe, who earned his OHSU medical degree more than four decades ago. Since Sacred Heart and OHSU first established the state’s inaugural pediatric telemedicine connection, more than 110 critically ill pediatric patients in Eugene have been treated through this high-tech network.
The secure high-speed broadband wireless connection and 24/7 availability of pediatric intensivists means an OHSU Doernbecher doctor and the Sacred Heart doctor are working together at the patient’s bedside minutes after OHSU receives a request for a consultation. The OHSU physician can monitor the patient’s vital signs, read X-rays, collaborate with the local physician and address a family’s concerns—just as if she was standing in the room. “It’s putting new tools in the physician’s medical bag,” said Dr. Roe.
When Sacred Heart pediatric nurse manager Jill Burrell, R.N., first suggested telemedicine, Dr. Roe saw the potential. He knew that Eugene didn’t have a large enough population to support its own pediatric intensivist, yet a critical care need remained. Moreover, about a third of the pediatric patients transported to OHSU ultimately didn’t require hospitalization in the PICU and returned to Eugene after a few days in a regular hospital ward. Telemedicine, Dr. Roe realized, could solve some of these problems. “It’s the next best thing,” he thought, and helped Burrell as she championed making the telemedicine connection with OHSU.
“Being able to spare many families a trip to Portland and all the costs associated with that—lodging, food, leave from work—has been great,” Dr. Roe said. He added, “In the long run, the quality of care is safer and better.”
The OHSU Telemedicine Network connects 10 Oregon hospitals to OHSU pediatric intensivists, neonatologists, stroke neurologists, trauma surgeons and other specialists.
Overall, more than 25 percent of the patients treated through the OHSU Telemedicine Network have been able to stay in their hometown hospital, saving families and insurance plans throughout Oregon an estimated $700,000 in emergency transport costs.
There are hurdles to overcome—including credentialing and licensing requirements—as well as reimbursement issues. Still, Dr. Roe expects telemedicine will expand. “There’s no question rural America will benefit from this,” he said.
Pictured: (top) Miles Ellenby, M.D., (bottom) Thomas Roe, M.D. '61