“I couldn’t speak clearly and whatnot, I was slurring, and I was leaning to the left side.”
When Leslie Welborn had his stroke, he was 100 miles from Houston’s Medical Center and the best stroke neurologists in the region. The retired mechanic was at home in Vidor, near Beaumont.
“Well, it started out I lost feeling in my left hand and I dropped a coffee cup and it broke and I didn’t realize I had even dropped it. I just — there was no feeling at all.”
At St. Elizabeth’s hospital in Beaumont, the ER doctors suspected stroke. But they weren’t sure if it was safe to give Welborn the newest, most aggressive drug. So they used a two-way video linkup to consult a stroke neurologist at St. Luke’s Episcopal Hospital in Houston.
Welborn got a powerful drug called TPA, and he’s lucky he did. TPA is a clotbuster. It can prevent paralysis and other brain damage from stroke, but only if given within three hours.
Jennifer Jefferson from General Electric helped set up the telemedicine link between St.Luke’s and St. Elizabeth’s.
“So 90 miles away, 100 miles away from here, that patient if he had to have been transported here, that would have been just more time that his brain was dying.”
Telemedicine is exactly what it sounds like: a long distance doctor’s exam. It’s used a lot in prisons, on oil rigs, or any situation where doctors and patients can’t physically connect. UTMB in Galveston is a national leader in telemedicine. Doctors there conduct about 60,000 remote exams every year, many on Texas prisoners.
In the free world, telemedicine is still finding its feet. Stroke is one of the most promising applications, largely because of a severe shortage of neurologists. Dr. James Grotta, chief of neurology at Memorial Hermann Hospital, remembers that before telemedicine, he would race from hospital to hospital to give TPA to stroke patients.
“We got pretty tired out, and so when telemedicine came along it became clear we could just put a camera in these emergency rooms so instead of running traffic out to Memorial Southwest we could just simply go into my office next door, turn on the computer, and there I’m looking at the patient, the patient is seeing me, I can see their imaging, and it worked beautifully.”
(Keyboard typing noise)
Dr. Jose Suarez is logging into the Telestroke network at St. Luke’s. He’s the neurologist who treated Leslie Welborn from 100 miles away. He says it’s almost like being in the same room as the patient.
“I’m able to ask them questions and give them directions, for instance, lift your arm, or close your eyes, open your mouth, they’ll be able to do all that. I’ll be able to talk to the family members at the other end, they’ll be able to see my face.” The advances in technology could help rural hospitals contact experts far away. But telemedicine’s chief obstacle is familiar to the founders of Facebook, Twitter, and other Internet based tools — how do you make a profit or just break even?
Again, Dr. James Grotta:
“Medicare and insurance does pay occasionally for a telemedicine consult but it nowhere comes close to compensating me for the amount of time I’ve got to be on call and the amount of time it takes to do a consultation.”
While telemedicine searches for the best business model, the inventions keep coming. Obstetricians can now use an iPhone app to track fetal heartbeat and labor at a distance. In the future, our phones or watches might be able to detect irregular pulses or falling glucose levels, and alert our doctors. From the KUHF Health and Science desk, I’m Carrie Feibel.