WakeMed Health & Hospitals System, an internationally recognized leader in innovation in medical care, has integrated physicians, staff, patients and their families with iPhone applications and resources that fully integrate prehospital, hospital, critical care and post-hospital care, making WakeMed care a virtual medical environment. Read about this innovative linkage of people, caregivers, technology and medical resources.
JEMS Editor-in-Chief, A.J. Heightman, MPA, EMT-P
When the parents of a sick baby from Smithfield, NC met Tara Bastek, MD, was introduced to the parents of a sick baby sitting at home one evening, she said was glad she wasn’t wearing bunny pajamas.
A neonatologist for a physician group who cares for sick babies in hospitals throughout Wake County, NC, Bastek uses the iPhone to video conference with parents in county and outlying hospitals, parents who are being asked to release their children into the care of these care teams.
On call for her medical group that night, Bastek spoke with the nervous parents of a baby who was about to be transported to WakeMed Health & Hospitals in Raleigh, NC from Johnston Medical Center in Smithfield, NC.
“We initiated a pilot where physicians and transport staff had an iPhones to link together using Facetime videoconferencing to discuss the patient at the hospital site," said Mark Piehl, MD, medical director of WakeMed Children’s Hospital.
With the Facetime linkup, the physician can see the patient, view monitors, talk with the parents and, if necessary, the patient, then formulate a plan with the transport staff,” Piehl said.
Rapid Access to Information
Not all smartphone use is quite as adventurous as video conferencing, but can be just as helpful. Jim Palombaro, MD of Wake Emergency Physicians, PA, said that looking up pharmaceutical information using the iPhone's Epocrates app is particularly helpful in patient care.
Graham Snyder, MD, from the same group, agrees. “No one knows everything,” he said. Rapid access to information, like dosages, indications and how pharmaceuticals react with one another used to be carried around in a series of booklets carried in doctors’ pockets. "These booklets have been largely replaced by the iPhone," he said.
In another use of the iPhone, paramedics now provide emergency department staff with photographs of the accident scene so that physicians better understand how the patient was injured, Snyder added.
Physicians are also texting information and photographs to each other using smartphones. What are the ramifications for patient privacy? It's hospital policy that health care providers separate personally identifiable information from, for example, images, or X-rays of the patient when emailing, texting, or videoconferencing.
Amar Patel, Director of WakeMed’s Center for Innovative Learning investigated and designed the video conferencing pilot study. Patel said that while he understands that there are concerns about patient privacy, he thinks virtual face-to-face video conferencing is more private than telephone conferences.
Dr. Bastek reinforces this notion. Parents give consent for the patient information shared through video and emailed pictures, Bastek said. She stressed that most parents wish to assist with their child’s care and are less concerned about privacy.
Bastek said that smartphones have enabled parents to make videos of symptoms their children exhibit even before they arrive at the hospital. It's a way parents can show health care providers behavior that may not easily be repeated, such as a seizure, Bastek said.
Putting Parents More at Ease
She noted that when babies need to move to a bigger hospital, “parents often say it is so unnerving to see their child put in an ambulance and they literally disappear.” Personally connecting with the family before Mobile Critical Care Services transports the baby puts a face to their child's caregiver, and comforts the parents.
“It makes families feel better connected to where their child is going to, especially knowing who will be caring for their baby. Video conferencing really helps with that.”
While transferring a child to bigger facility for more specialized care stresses parents, the personal touch of doctor and parents meeting face-to-face in a virtual environment boosts parents' confidence about the care their child will receive.
In the right hands, the iPhone is a tool that is becoming more commonly used in uncommon ways, to assist in patient care in ways that few people could have imagined only several