A child is injured. Seriously injured. Or possibly sick. Really, really sick. Panic starts to set in. Parents and grandparents become frantic. Is there time to drive 100 miles or more to get to a first-rate pediatric hospital or should the child be treated here in Vero Beach, a place that because of its older population is not known for exceptional pediatric care
Now that frightening decision can be avoided, thanks to the phenomenon of tele-medicine.
Today some of the finest pediatric specialists and sub-specialists in the entire nation – and possibly even the world – are on-call 24 hours a day at Vero Beach’s Indian River Medical Center.
All the expertise of one of the country’s most well-regarded pediatric care facilities, the $400 million Nemours Children’s Hospital in Orlando, can now be accessed instantly at the IRMC emergency room thanks to an alliance between these two hospitals and a digital communications program called CareConnect.
The U.S. Department of Health and Human Services calls programs like CareConnect, “An important part of the strategy to improve health service delivery. It can link distant sites with more resource-rich sites and has the potential to dramatically improve pediatric care.”
Dr. Shayan Vyas, pediatric critical care interventionist and the medical director for Nemours’ CareConnect in Florida, along with IRMC emergency care physician Dr. Michael Farrell and Susan Slade, RN, assistant medical director of the Vero Beach hospital’s emergency services, are convinced this new program has already and will continue to help save young lives here on the Treasure Coast.
Using iPads, pediatric doctors at Nemours can consult directly with ER physicians and nurses at IRMC. They can check vital signs and see the skin tone, eyes, demeanor and overall appearance of the child. They can also see and speak directly to the child’s parents and the parents can see and speak with the Nemours specialists.
“One of the best things,” exclaims Vyas, “is that we’re often able to keep kids in their communities and still provide specialist care.”
Videoconferencing has become so commonplace in the business world and in social media that most people are now as comfortable communicating through pixels on a screen as they are in person.
“I’ve never had a negative reaction,” says Farrell. “When parents see someone is on the other end and is giving them a plan, they realize right away it’s just like having a pediatric specialist walk into the room.”
Of course, some childhood illnesses and injuries are more severe than others and sometimes that means having to transport a young patient up to the Nemours facility in Orlando. Most hospitals simply can’t afford to keep dozens of pediatric specialists and sub-specialists such as pediatric radiological oncologists on staff and sometimes those specialists aren’t even available in the area. In fact, according to Vyas, the pediatric radiological oncologist at Nemours is the only one in the state of Florida.
If a child does need to be transported, CareConnect can help there, too. Farrell explains that his colleagues at Nemours can, “tell us to give X-medication or Y-medication and they really help us to prepare the patient for transport.”
Cases that may require transport can include acute and chronic respiratory failure, airway obstruction, sepsis and septic shock, circulatory shock, acute kidney failure, liver failure, diabetic ketoacidosis, severe electrolyte abnormalities, heart rhythm problems, neuromuscular diseases, blood and cancer-related complications and severe poisoning.
Slade knows just how traumatic it can be for parents to learn their child has to be taken to a distant hospital, and quickly points out another benefit to CareConnect.
“It’s great for the parents, because with CareConnect, they just saw and spoke to the nurse or the doctor who’s going to be taking care of their child. When they get to Nemours they’re going to look for that nurse or that doctor they saw on our screen here.”
“You can go from a family that’s almost hysterical,” Slade explains, “to one saying, Great! When can we get going?”
In the most serious cases, Farrell will call for the fastest transportation possible: A helicopter.
“If we have someone who’s in extreme crisis,” states this University of Liverpool Medical School graduate who served his internship at Mt. Sinai Hospital and his residency at Richland Memorial, “we’ll get a helicopter in here. We’ll put the patient in with a good team and off they go.”
Slade agrees. “It’s an hour and a half drive even with lights and sirens on,” says the emergency services assistant director, “so in critical cases, a helicopter is best.”
The folks at Nemours seem to concur. This October, the Orlando hospital is hosting a major fundraising event with an eye on purchasing its own helicopter. (For details see: www.nemours.org/givingtonemours/events/2015/orlgala.html.)
While this videoconferencing alliance between IRMC and Nemours of Orlando has only been in effect for a short five months, Farrell says, “There have been many, many cases already,” in which CareConnect has made a life-saving difference and he expects those numbers to continue to grow.
So does the American Academy of Pediatrics. It calls programs like the Nemours-IRMC CareConnect alliance, “an increasingly important component of pediatric care.”
Carey Officer, director of service delivery innovations at Nemours proudly claims that with CareConnect, “We bring the pediatric specialists to the patients.”
For parents in the Vero area, Vyas puts it even more simply. “Get connected to CareConnect,” he says, “it’s powerful stuff.”