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Carle Telemedicine

Telemedicine is a revolutionary delivery system for medical services that connects specialists at Carle with healthcare providers and their patients in rural communities. Using the latest telecommunication technology Telemedicine brings medical consultations, follow-up care and educational services directly to rural physicians and hospitals.

How Telemedicine Works

Telemedicine uses special high-speed phone lines and the most advanced computer and visual communications equipment to instantly connect specialists with patients in rural communities across east central Illinois. Computers and cameras installed at Carle and participating hospitals and clinics enable doctors to examine patients and discuss treatments. Two-way "live" verbal and visual communication allows a patient to ask and answer questions, and explain symptoms to a physician.

Who Benefits From Telemedicine?

You do. And so do all residents of rural areas because telemedicine makes intelligent use of medical resources for rural hospitals, emergency rooms, and family practice physicians who refer patients to specialists. As a patient, telemedicine will save you the time and hassle of traveling for medical consultations. Additionally, it enhances your care by allowing your primary care physician, and even your family to be present with you during a consultation.

Home Telemedicine

Home Telemedicine is a way of providing care, monitoring, and education to patients in their homes through the use of live, interactive telecommunications.

TeleHomecare is an exciting new field of medicine that allows healthcare professionals to monitor patients, who remain in the comfort of their how homes. During the "videovisit" with Carle Home Care, the patient and the registered nurse can both see and hear each other using technology that functions over an ordinary telephone line. In addition to the audiovisual component, the RN may:

Monitor blood pressure and pulse
Monitor medication compliance
Observe wound healing process
Listen to heart and lung sounds
Obtain other information such as blood glucose, and temperature.

TeleHomecare is a convenient means for patients to have instant access to their care providers for monitoring, assessment and educational purposes.

TeleHomecare has gained increasing interest from homecare administrators in the past few years. 1998 statistics cited close to 100 home care agencies currently doing some type of in-home telecare across the country. Studies have shown that providing ongoing interactive consultations with patients in the home does significantly reduce the number of times the patient is taken to the ER or is admitted to the hospital.

About Home Services and Telecare

Carle Home Services has been providing in-home telecare since December 1999 - the only Illinois location conducting in-home teleconsults outside the Chicago area.

Carle's program can provide care to any patient. The program has concentrated on cardiology patients - primarily those with congestive heart failure and patients requiring complex wound care in the home at Carle. The tele-visits are done either in addition to actual in-home skilled nursing visits, or are continued after the patient is discharged from homecare services.

Carle Home Services has serviced a total of 35 patients. They service up to 20 patients per month. They make an average of 120 videovisits per month.

Carle Home Care uses two different video units. These units use a regular phone line in the patient’s home, so no additional telephone lie or special line is needed. For cardiology consults they use the American Telecare's Aviva 1010 patient unit. This has a built-in analogue stethoscope and blood pressure cuff so the home health nurse can accurately gauge any changes in blood pressure and heart rate.

For in-home wound assessments, a smaller unit is being used, called a VIA TV videophone (Interlogix,Inc., formerly 8x8, Inc.). These units do not have the peripherals, such as stethoscopes or blood pressure, but are small, portable units that have an enclosed camera. This enables not only an assessment but a digital picture to be taken of the wound. A picture of the wound can then be transmitted to the physician.

The goal of this grant-funded project is to see if the addition of tele-homecare resulted in fewer hospitalizations and ER visits. A twelve-month comparison is used to compare patients to their former hospitalization and ER visit record.

In the case of wound care assessments; the program will evaluate the number of re-hospitalizations and reduction of time it takes for the wound to heal.

For more information about Carle Home Services TeleHomecare program, contact any of the following individuals at (217) 383-3488:

Chris Fouse, RN, primary for the Telemedicine cardiology patients

Alice Kerkering, RN primary for the Telemedicine wound patients

Ellen McComb, Carle Home Care Manager

Susan Ruwe, Carle Home Care Supervisor

Julie Bowen, Carle Home Care Supervisor

Selection Criteria For Determining TeleHomemedicine Need

Criteria:

Patient willing to participate in the Telemedicine program

Patient is seen by Carle Home care

Patient has a functioning phone line.

Patient is able to perform self-care or has a willing and able caregiver.

Patient is under the care of a licensed physician.

Patient is agreeable to participating and being compliant with an established home care treatment plan

Patient has complex and/or daily medical needs that require the skilled nursing intervention.

Examples of patients who would benefit from TeleHomemedicine:

Patients who require frequent hospitalization and/or emergency room assessment

Patients who require chronic disease management

Patients with wound and/or ostomy care

Patients on IV therapy at home

Hospice patients

Patients with educational needs on medications and/or disease management

Patients who have distance and/or transportation issues

Patients where more frequent assessment would increase patient compliance.

Hospital and Clinic Telemedicine Partners

Carle emergency room physicians serve rural hospitals via telemedicine, by working in conjunction with a local physician assistant. This way, communities maintain access to local emergency room service and patients receive high quality medical assistant provided by board-certified emergency physicians at Carle's Level I Trauma Center.

Local physicians have the expertise of Carle's specialists at their service for examinations and consultations. Patients in need of surgery have the options of pre-operative consults and follow-up visits through telemedicine.

Carle Telemedicine connects to these Carle Clinic sites:

Bloomington/Normal
Danville
Mattoon-Charleston
Champaign
Monticello (Kirby Hospital)

Carle Telemedicine connects to these hospital sites:

Crawford Memorial Hospital (Robinson, IL)
Paris Community Hospital (Paris, IL)
Hoopeston Memorial Hospital (Hoopeston, IL)
The Pavilion Mental Health Facility (Champaign)
The Carle SurgiCenter (Champaign)
Carle Cancer Center at St. Anthony's (Effingham, IL)

Clinical Applications

Neurology – follow-up consults
Attention Deficit Disorder (Pediatrics) – diagnosis
Wound Management – evaluation, consultation for care and treatment
Oncology – patient exams; radiation treatment planning
Post-Surgical – follow-up consults

Educational Applications

Continuing Medical Education for physicians, nurses and other medical professionals
Orthopedic Hand Conference
Cancer Conferences
University of Illinois College of Medicine Residency with Danville VA Hospital
Pediatrics

Telemedicine & Videoconferencing Equipment

Transmission: T-1 and ISDN 384 kbps on IP network, Radvision MCU.

PolyCom ViewStations: PolyCom 512 units, which are interactive, TV-based, and easy to use with a remote. PolyCom VS 4000’s are larger room-based units used primarily for videoconferencing meetings and education in The Forum. Two rooms in the Forum have this capability- The Pollard Auditorium and the Videoconferencing Room on the lower lelvel.

High-Resolution Cameras: The Zydacron cameras have remote zooming and moving capabilities, which enables the doctor to closely observe patients - even eye movements and reactions to motor skills, flexibility, and mobility tests.

Hand-Held Zoom Camera: Since this small, hand-held patient exam camera has a macro lens, the physician assistant or nurse can use this equipment to zoom in on the smallest of details. Provides good-to-excellent images of wounds. In this way specialists can evaluate patients' wounds, incisions, and even examine eyes.

Stethoscope: Carle uses an American TeleCare analogue stethoscope which employs multiple frequencies to allow doctors to listen to heart and lung sounds as with a regular stethoscope.

Document Camera: These ELMO cameras typically have a base and a camera head much like an overhead projector. They can be purchased with side lights and a base light (for transparencies and x-rays). Enables Carle specialist to review X-rays and EKG readings.

Home Health: Carle's Home Services uses American TeleCare's Aviva 1010 patient units and 8x8's for wound care assessments in the home.

Videoconferencing

Videoconferencing is the linking of one group or person to another group or person by interactive computers to conduct meetings, presentations, or education. Carle uses a dedicated videoconferencing room to communicate with eight sites throughout east central Illinois.

Videoconference Partners:

Carle Clinic sites