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Telemedicine Links Remote Docs With Ill Kids

Videoconferencing, digital cameras, and robotics help critical care doctors working from home supervise treatment of pediatric ICU patients.

A new telemedicine program at Massachusetts General Hospital is helping doctors manage the care of critically ill children around the clock. The new Connected Pediatric Critical Care program enables on-call attending physicians from their homes examine patient and communicate with on-site pediatric ICU staff using real-time video conferencing and robotic gear.

The program, launched last May, involves six pediatric critical-care attending physicians equipped with videoconferencing computer units in their homes, allowing them to connect to a portable robotic telemedicine station -- nicknamed "PICU Bot", or "Bot" for short -- that can be rolled to the patient's bedside.

Digital cameras and medical scopes are attached to the bedside unit allowing the physician to remotely control robotics that move devices for examining the patient. Meanwhile, videoconferencing capabilities allow the doctor to talk with on-site hospital clinicians, respiratory therapists, and other specialists, as well the patient and child's parents.

The PICU Bot was assembled by Mass General IT and clinical staff using "off-the-shelf" components, said Dr. Joseph Kvedar, director of the Center for Connected Health, a division of Partners Healthcare, which owns Massachusetts General Hospital.

The PICU Bot telemedicine videoconference infrastructure consists of six small videoconference units -- Polycom V700s -- which are located in the attending doctors' homes, said Michael Carter, a Mass General project leader. In addition, there is a mobile high definition videoconference unit -- Tandberg Edge 95 -- located in the pediatric ICU at Mass General.

The at-home doctors control the robotic cameras and medical scopes via the Polycom system, said Carter.

The system is designed to be user-friendly where dialing a single number allows authorized users access to the system, yet secure enough, so that no one outside of the authorized users can call into the PICU or physician's homes, Carter said.

"Our group maintains the system and supports the doctors when issues arise," he said.

"The system is scalable, where we can add more physicians down the line, or offer similar services to partnering hospitals," he said.

The use of PICU Bot is being studied by Mass General to see how improved communication between attending physicians and ICU staff impacts critical care, said Dr. Natan Noviski, chief of Mass General's pediatric ICU. The study will also help Partners Healthcare decide whether to roll out telemedicine "Bots" and videoconferencing capabilities for use in its other hospital ICUs for adult patients.

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