Telehealth provides help with neurology shortage

ROWLETT, TX – Finding certified neurologists is becoming more difficult as many hospitals face shortages in all areas. Through a service called Specialists on Call, some hospitals are getting neurologists to the patient’s bedside – fast.

Westlake Village, Calif.-based Specialists On Call Inc. (SOC) provides trained specialist physicians on call 24/7 to urban, suburban and critical access hospitals using videoconferencing technology. According to CEO Joe Peterson, MD, there are about 40 neurologists on staff, serving about 60 private community hospitals.

The SOC neurologists use videoconferencng technology from New York-based TANDBERG.

Tandberg’s equipment serves to “bring the right person to the right place at the right time,” says Joe D’lorio, government, educational and medical manager for healthcare at TANDBERG.

Lake Pointe Medical Center, a full-service 112-bed hospital in Rowlett, Texas, began using SOC’s services in its ED in April 2008.

Joanna Kestler, RN, director of emergency and outpatient services at Lake Pointe, says they use SOC about four to five times a month and can get a specialist to the patient’s bedside within 15 minutes.

“Like any technology it is not 100 percent immune to failure,” said Colin McDonald, MD, founder of SOC. “We have to protect against failure, and we do this through redundancy of the physician staff.”

Peterson says the redundancy plan consists of “two layers” of back-up physicians.

When a patient has a stroke, an important, quick decision ER physicians must consider is whether to administer a clot-busting drug called tissue plasminogen activator (tPA). This drug is given to treat patients with an ischemic stroke and must be administered within the first three hours after the start of symptoms.Kestler says SOC has helped them to administer tPA in two cases.

“It’s always a concern that patients may be skeptical (of videoconferencing), but once they see it, folks have been very receptive because of quality of feed and interactiveness,” said David French, MD.

“It’s a benefit to the community, especially as our area continues to grow,” he says.

The on call neurologist will have a phone conversation with the ER physician and review the patient’s medical history and CT scan before using videoconferencing to perform a nurse-assisted exam of the patient, Kestler says.  

Doctors in the ER use a secure portal, which is part of SOC’s infrastructure, to send patient information to the neurologists on call. A spokesman for the company says the infrastructure is known as “IronWorks” and it includes a 24/7 call center, a real time PACS, a clinical information and electronic medical records system, and the videoconferencing equipment.