Implementing tele trauma & teleemergency in georgia

Teletrauma: Putting it all Together Rich Bias, Sr. VP MCG Health Debra Kitchens, RN, Trauma Program Manager MCCG Cyndie Roberson, RN, Director of Patient Intake, CHOA

Background and Significance Disparities exist in trauma morbidity and mortality based on a rural or urban care setting The relative risk of a rural victim dying in a motor vehicle crash is 15 times higher than in urban areas Injury related deaths are 40% higher in rural communities 87% of rural pediatric traumas do not survive to reach the hospital

Rural ED Solution: Rural ED Teletrauma Network Level I Rural ED Trauma Center•  Program began July 2009•  Goal – to enable rural emergency department practitioners and trauma patients access to a team of surgeons and specialists at a Level I Trauma Center•  Innovative and cutting edge technology used to save lives, increase efficiency, and improve the level of care

Phase IRegion V: Trauma Center Medical Center of Central Georgia Rural Partners Dodge County Hospital Fairview Park Hospital Peach Regional Medical Center Taylor Regional Hospital

Advantages to Teletrauma Network •  Enable rural trauma team to virtually add a trauma specialist to their response team •  Utilizes real-time visual link which greatly enhances the trauma specialists ability to participate in care •  Improved communication, improve continuum of care •  Improve relationships between health care providers• Aid in the initial evaluation, treatment, and care of thepatients which can improve outcomes and reduce cost

Results from Phase I •  Positive attitude toward use of the telemedicine system •  73% indicated that using telemedicine is a good idea •  80% reported that using telemedicine is a positive step •  87% reported they plan to use telemedicine for trauma in the future •  53% noted that using telemedicine increases their effectiveness •  58% found system useful in their jobs •  Clinical Outcomes •  67% reported using system makes it easier to evaluate patients •  Overall satisfaction was reported to be 69%

Moving Forward Phase II: 2 additional Level I Trauma Centers, 1 Pediatric Specialty Center and 18 Rural Hospitals MCG Health, Inc Memorial Health University Childrens Healthcare of Medical Center Atlanta•  Emanuel Medical •  Jeff Davis Hospital Center •  Bacon County Hospital •  Habersham County Medical•  Washington County •  Effingham County Hospital Center Regional Medical •  Satilla Regional Medical •  Chatuge Regional Hospital Center Center •  Miller County Hospital•  Burke Medical Center •  Coffee Regional Medical•  Jefferson Hospital Center•  McDuffie Regional Medical Center

Phase II Process andImplementation Identification of Rural Partners•  Transfer patterns to Trauma Centers Credentialing•  By Proxy Credentialing Training/Inservice• Basic Inservice• Advanced end to end process testing Process Go Live• Trauma Physician availability 24/7

Telemedicine Process and FlowEnhanced access to specialty consultation Through enhanced resources Patient Arrival in Rural Emergency Room physician collaboration increases the likelihood of a positive Notification to Level I trauma Center outcome • ATLS stabilization and transport guidelines and principles can be Collaborative Evaluation through telemedicine enhanced primary and directed by the trauma surgeon secondary survey • Mutual decisions for patient Synergistic determination for treatment plan and patient disposition disposition ensure the most efficient use of resources without compromising outcome Evaluation and Outcome . Patient transferred to Level I Patient remains at local hospital for Trauma Center for further care evaluation and treatment

Phase II Evaluation• Use of a standardized process will allows comparison of outcomes for all sites• Additional component added to determine perceptions influencing intentions of traumaand emergency team members to support the use of a telemedicine system for trauma• Specific Questions: • What are the perceptions of trauma and emergency team members about the use of a telemdicine system for trauma • What are the relationships between pre and post implementation perceptions and intentions to support the use of a telemedicine system for trauma • What effect did the use of a telemedicine system have on the number of transfers to the Level I trauma center

Based on the outcomes from Phase I and Phase II ofthe project next steps will be determined.The goal is to be able to provide telemedicine servicesfor trauma care throughout the state of GeorgiaQuestions ?

Implementing tele trauma & teleemergency in georgia

by Lloyd Sirmons on Mar 15, 2011

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