Mobile Telemedicine Helps Patients In Transit

Telemedicine gear often helps patients and clinicians connect with remote physicians, but for the most part, those interactions typically take place from "fixed" locations, such as a home or office within another medical facility. However, a new telemedicine configuration developed with clinicians from Cincinnati Children's Hospital Medical Center is linking patients in ambulances with remote medical specialists.

"This is telemedicine on-the-go," said Dr. Hamilton Schwartz, who came up with an idea for using high-resolution video and other telemedicine gear, such as digital stethoscopes, for pediatric patients -- including sick premature infants -- while these children are in transit to Cincinnati Children's Hospital Medical Center (CCHMC) from other area hospitals.

In pediatric healthcare, especially cases involving critically ill children, care often needs to be delivered while the patient is being moved from one facility to another. But emergency or intensive care specialists at the destination hospital can get a head start in delivering care to those sick patient if the clinicians can remotely examine and observe the patient prior and during to transit, said Schwartz.

"A picture is worth a thousand words, [but] there is no substitute for seeing a patient with your own eyes," he said.

Schwartz, medical director of CCHMC's critical care transport team, and his wife, the medical director of neonatal critical care for the team, frequently use webcams to connect with family in Texas.

This got Schwartz thinking about the possibility of using camcorders, webcams, and telemedicine gear in moving ambulances for assisting in the care of sick patients being transported to intensive care or other specialty care units of hospitals.

Schwartz and a small group of other clinical staff at CCHMC were helped in their pondering with a $75,000 state grant to fund projects that could assist patients in situations involving mass causalities, floods, or other crises, he said.

Schwartz teamed up for the design and development of the in-transit telemedicine solutions with Global Media, which provides other telehealth solutions.

Among Global Media's products now part of the new Transport AV telemedicine offering is TotalExam, a high-resolution hand-held camera the size of a dry-erase marker. It can be used for examination of patients' throats, eyes, and skin from an Internet-connected remote PC or videoconferencing system.

The Transport AV mobile telemedicine solution mounts on a stretcher and supports 3G, 4G, and 802.11 networks. Its TotalExam camera can be used for video or freeze-frame pictures if there isn't enough network bandwidth in the region for clear images in motion, said Joel Barthelemy, Global Media managing director. An integrated digital stethoscope is also offered as an option.

CCHMC recently began beta testing Transport AV in delivering care to neonatal patients who are in transport to the hospital.

Barthelemy expects the next generation of Transport AV to be "weatherized" for use during car accidents and other events. The Transport AV is priced at about $30,000, said Barthelemy.

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