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Presentation by Joe Tracy, Vice President, Telehealth Services, Lehigh Valley Health Network
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The LVHN TeleBurnSM Program
Mid-Atlantic Telehealth Resource
Center Summit
March 15-16, 2012
Joe Tracy
VP – Telehealth Services
Program Purpose
■ To assess burn patients quickly by both the local Emergency Room attending physician and an LVH Burn Surgeon.
– Initiate treatment earlier!
– Triage Enhancement through Collaboration with a Regional Burn Center.
What is so innovative about
LVHN TeleBurnSM?
■ Outreach strategy involving:
– A service not typically offered by many small hospitals.
– Visits and presentations to remote sites by:
• Burn Center Medical Director
• VP of Telehealth
• TeleBurn Liaison (on-going sales and service)
– Information Services providing the technology support.
What is so innovative about
LVHN TeleBurnSM?
■ Outreach strategy involving:
– Simple and inexpensive technology for the remote site.
– Agreements between LVHN and the sites.
– The Guide to Getting Started with LVHN TeleBurn.
– 24/7/365 response by LVHN Burn Surgeons
– mHealth technologies used at LVHN
Back to the Future
Emergency Telephone Call – Burn
Remote Physician Description
■ 83 year-old male
■ Burned his lower leg yesterday while burning brush with gasoline.
■ His burn looks to be about 0.5% TBSA.
■ Wound is pink and moist with blistering.
■ Patient has a history of diabetes and heart disease as well as mild dementia.
■ I would like to treat him here and refer if there are any complications with healing.
Additional Conversation
■ Burn Surgeon: Is his pain controlled and
does there appear to be any signs or
symptoms of cellulitis.
■ Remote Dr.: His pain is controlled and he
does not have any signs of cellulitis. His
wound looks pink.
■ Burn Surgeon: Does the wound blanch?
■ Remote Dr.: It appears to blanch in the
area of blister…..
Do you have the image of this burn
in your mind?
Case Summary
■ TELEPHONE – Same verbal
communication – No Visual – .5% burn TBSA – Pt. probably treated
local and sent home. – Big chance for
infection – If wound becomes
infected – two surgeries vs. one
■ TELEHEALTH – Same verbal
communication – Couple Digital Pics – 1.5% burn TBSA – Pt. transferred to
LVHN Burn Center – No infection due to
timely treatment – One surgery – next
day – discharged on day 5
Important Points to Make Based
on the Summary
■ Telehealth provides a better assessment of
the patient, because providers are not
working blindly.
■ Payor implications – two surgeries vs. one
and corresponding LOS differences.
■ Think about the legal issues of
mistreatment.
■ MOST IMPORTANT – think about the
implications for the patient.
LVHN TeleBurn by the Numbers (December 2008 – Current)
■ Hospitals
– 37 installed
– 7 pending installation
– 10 pending agreements
– 4 contacted
– 8 on the radar screen
■ Industry partners
– HealthWorks
– Just Born
– Deka Batteries
TeleBurn Encounters To Date
(December 31, 2011)
38%
36%
15%
11%
Admitted to BC
Outpatient BC Only
Remained Local
Other
N = 1132 patients
TeleBurn Encounters by Month
0
10
20
30
40
50
60
70
Jul
Aug
Sep Oct
Nov
Dec
Jan
Feb Mar
Apr
May Ju
n
FY 2011 FY 2012
Declining Cost to Implement
TeleBurn
■ 2008 TeleBurn – Version 1 - ~$5,000
■ 2009 TeleBurn – Version 2 - ~$2,400
■ 2009 TeleBurn – Version 3 - ~$400
Too Cumbersome!
LVHN TeleBurnSM
Make Sure You See
The Entire Picture!
Picture – courtesy of Robert Schosser, MD, East Carolina University
Accurate Verbal Description, but
the Picture Tells the Story
Picture – courtesy of Robert Schosser, MD, East Carolina University
Summary
■ Enhanced communications by adding a couple pictures to the conversation.
■ Implemented a web-based, mHealth solution to speed up the emergent conversation.
■ Built a solid outreach program around the program.
■ Provide on-going support to the TeleBurn sites!
Questions & Answers
My Contact Information:
Joe Tracy
Vice President – TeleHealth Services
(484) 884-8633