Stroke patients at Dignity Health hospitals on the Central Coast may find a robot at their bedside, allowing expert neurologists to “beam in” and support local physicians providing treatment.
French Medical Center in San Luis Obispo, Arroyo Grande Community Hospital and Marian Regional Medical Center in Santa Maria have launched a neuroscience and stroke program in conjunction with Dignity Health Telemedicine Robots.
The program pairs neurologists with local emergency department physicians needing to consult with a specialist about stroke or other neuroscience patients.
Using a life-sized robot, neurologists miles away from the Central Coast can help evaluate patients in the hospitals’ emergency departments.
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The telemedicine program uses neurologists from the Mercy Medical Group in Sacramento, a division of Dignity Health Medical Foundation. The group provides telemedicine services to 22 hospitals, primarily in California.
The robots connect physicians at the hospitals with experts around the clock, which is especially vital when local on-call neurologists may not be available.
“We really have this as a backup at French and Arroyo Grande,” said Kirsten Featherstone, a registered nurse and Dignity Health Central Coast Neuroscience Services manager. “At those hospitals there is full neurological on-call coverage. All days are covered.”
At Marian, however, local neurologists are only available half time, she said. “Using telemedicine allows us to provide that neurologic expertise every day, rather than just half the time, to support our emergency department physician colleagues and the hospitalists,” Featherstone said.
The life-sized robot employs two-way video and audio feeds so a doctor can remotely assess a patient, by having a stroke victim identify images or words, reviewing test results and zooming in on a patient’s pupils.
“One of our neurologists likes to say the pupil is the window to the brain,” Jason Close, a Dignity Health program manager, said as he demonstrated from his out-of-town location the robot’s zooming capability by getting a detailed look at a pen sitting on a table several feet away.
“It’s very good image quality on the camera,” he said.
A neurologist can swivel the camera to look at the screens of equipment monitoring a patient.
The robot has been in use at Arroyo Grande since June and at Marian since April, Featherstone said, with plans to launch it at French hospital by September.
Each robot is programmed with the layout of the emergency department and through an auto-drive feature can make its way to into patient’s rooms.
The time from contacting the consultant until the expert is involved in the case averages between six and 10 minutes, Featherstone said.
The robot allows the neurologist to interact with the patient and then work with emergency physicians in coming up with a treatment plan.
The real time and “face-to-face” interaction make a big difference in caring for patients, said Dr. David Ketelaar, director of the Marian Emergency Department.
“Sometimes, it’s hard to convey some of the complex conditions some of these patients are having on the telephone to another physician,” Ketelaar said.
The expert, working with on-site nurses, also can conduct an assessment from afar.
“You can get a very quick feel for the level of the deficits someone has by just walking in the room and interacting with them,” Ketelaar said. “You can’t get that in a telephone consult of someone trying to describe it.”
The telemedicine program is part of an effort by Dignity Health to improve its stroke treatment protocols so that the three hospitals can receive certification as a Primary Stroke Center by the Joint Commission, which accredits hospitals nationwide.
“We’ve really been working at improving our response to stroke at all three of the Dignity hospitals,” Featherstone said. “The intent is that all three will be certified by the end of the year.”
In San Luis Obispo County, only Sierra Vista Regional Medical Center currently has Primary Stroke Center certification.