The LVHN Teleburn Program
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The LVHN TeleBurnSM Program provides telehealth consultations between local emergency room physicians and LVHN burn surgeons to quickly assess burn patients. This allows for earlier treatment initiation and triage enhancement through collaboration with the regional burn center. The program is innovative through its simple and inexpensive technology, agreements between sites, and 24/7 access to burn surgeon expertise. Case examples demonstrate how telehealth allows for better patient assessments and outcomes compared to telephone consultations alone. Since 2008, the program has expanded to many sites through an outreach strategy and declining implementation costs, demonstrating the benefits of telehealth for burn consultations.
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The LVHN Teleburn Program
- 1. The LVHN TeleBurnSM Program Mid-Atlantic Telehealth Resource Center Summit March 15-16, 2012 Joe Tracy VP – Telehealth Services
- 2. Program Purpose ■ To assess burn patients quickly by both the local Emergency Room attending physician and an LVH Burn Surgeon. – Initiate treatment earlier! – Triage Enhancement through Collaboration with a Regional Burn Center.
- 3. What is so innovative about LVHN TeleBurnSM? ■ Outreach strategy involving: – A service not typically offered by many small hospitals. – Visits and presentations to remote sites by: • Burn Center Medical Director • VP of Telehealth • TeleBurn Liaison (on-going sales and service) – Information Services providing the technology support.
- 4. What is so innovative about LVHN TeleBurnSM? ■ Outreach strategy involving: – Simple and inexpensive technology for the remote site. – Agreements between LVHN and the sites. – The Guide to Getting Started with LVHN TeleBurn. – 24/7/365 response by LVHN Burn Surgeons – mHealth technologies used at LVHN
- 5. Back to the Future
- 6. Emergency Telephone Call – Burn Remote Physician Description ■ ■ ■ ■ ■ ■ 83 year-old male Burned his lower leg yesterday while burning brush with gasoline. His burn looks to be about 0.5% TBSA. Wound is pink and moist with blistering. Patient has a history of diabetes and heart disease as well as mild dementia. I would like to treat him here and refer if there are any complications with healing.
- 7. Additional Conversation ■ Burn Surgeon: Is his pain controlled and does there appear to be any signs or symptoms of cellulitis. ■ Remote Dr.: His pain is controlled and he does not have any signs of cellulitis. His wound looks pink. ■ Burn Surgeon: Does the wound blanch? ■ Remote Dr.: It appears to blanch in the area of blister…..
- 8. Do you have the image of this burn in your mind?
- 10. Case Summary ■ TELEPHONE – Same verbal communication – No Visual – .5% burn TBSA – Pt. probably treated local and sent home. – Big chance for infection – If wound becomes infected – two surgeries vs. one ■ TELEHEALTH – Same verbal communication – Couple Digital Pics – 1.5% burn TBSA – Pt. transferred to LVHN Burn Center – No infection due to timely treatment – One surgery – next day – discharged on day 5
- 11. Important Points to Make Based on the Summary ■ Telehealth provides a better assessment of the patient, because providers are not working blindly. ■ Payor implications – two surgeries vs. one and corresponding LOS differences. ■ Think about the legal issues of mistreatment. ■ MOST IMPORTANT – think about the implications for the patient.
- 12. LVHN TeleBurn by the Numbers (December 2008 – Current) ■ Hospitals – 37 installed – 7 pending installation – 10 pending agreements – 4 contacted – 8 on the radar screen ■ Industry partners – HealthWorks – Just Born – Deka Batteries
- 13. TeleBurn Encounters To Date (December 31, 2011) 11% 15% 38% 36% Admitted to BC Outpatient BC Only Remained Local Other N = 1132 patients
- 14. TeleBurn Encounters by Month 70 60 50 40 30 20 10 FY 2011 Fe b M ar A pr M ay Ju n Ja n D ec Ju l A ug Se p O ct N ov 0 FY 2012
- 15. Declining Cost to Implement TeleBurn ■ 2008 TeleBurn – Version 1 - ~$5,000 ■ 2009 TeleBurn – Version 2 - ~$2,400 ■ 2009 TeleBurn – Version 3 - ~$400
- 16. Too Cumbersome!
- 17. LVHN TeleBurnSM
- 18. Make Sure You See The Entire Picture! Picture – courtesy of Robert Schosser, MD, East Carolina University
- 19. Accurate Verbal Description, but the Picture Tells the Story Picture – courtesy of Robert Schosser, MD, East Carolina University
- 20. Summary ■ Enhanced communications by adding a couple pictures to the conversation. ■ Implemented a web-based, mHealth solution to speed up the emergent conversation. ■ Built a solid outreach program around the program. ■ Provide on-going support to the TeleBurn sites!
- 21. Questions & Answers My Contact Information: Joe Tracy Vice President – TeleHealth Services (484) 884-8633 joseph.tracy@lvhn.org