Technology Helps Doctors Treat Neurology Patients Miles Away

Robert Kerlin enjoys physical activity like mowing the lawn. This retired firefighter has always led an active life, so at age 58 he was frustrated by some debilitating symptoms.

“[I had] severe headaches lasting 2-3 days,” said Robert. “I’d feel them coming on the back of my head, and it got to the point that I had blurry vision. That’s when I decided that’s a little bit more than vertigo.”

Then one Sunday in church he got so sick he thought he might pass out, so he took himself to the emergency room at ProMedica Memorial Hospital in Fremont, just a mile or so from his home.

Robert was surprised by the staff’s response. “They were calling for a stroke alert over the PA system, and I’m thinking, Aren’t they going a little bit too far with this? I didn’t even think it was a big deal,” he said.

But it was a big deal. Robert had all the signs of a stroke, so the team sprang into action with their tele-neuro cart, which allows neurology specialists from ProMedica Toledo Hospital to examine and diagnose patients remotely.

Robert remembered thinking, “I’ve got this machine coming in and a woman’s going to talk to me on it. I’m thinking ok, am I in Star Trek?”

It might seem like science fiction, but using video conference technology, much like FaceTime or Skype, neurologist Gretchen Tietjen, MD, and her team are able to see patients and talk to them in real time, even though they’re in cities miles apart.

“You can really do an awful lot at the bedside with this technology to get a good neurological evaluation,” said Dr. Tietjen.

Nurse Crystal Margraf is the doctor’s hands and another set of eyes during the exam. She does a variety of tests while the doctor observes and asks questions. Dr. Tietjen can also zoom in the camera to examine the patient’s eyes, which can tell her a lot.

“We bring the technology right to the bedside and she’s able to remote in and she usually takes about an hour of the patient’s time. I’m the nurse facilitator, so she’ll tell me exactly what she’s looking for and what assessment tools that she likes to use,” said Margraf. “She is pretty much at the bedside with the patient for roughly an hour, which is really a significant timepiece, where other consulting physicians may be in and out of the room within 15 minutes. But she really does a thorough exam and the patients have been really receptive to it.”

Dr. Tietjen added, “Many of the patients that I see that I’m able to do a neurological exam on, are able to stay at their local hospital and can get the same evaluation, same testing done there. It’s actually been a rarity of the patients that need to be transferred to a larger hospital.

“Many of the patients that I see are able to stay at their local hospital and can get the same evaluation, same testing done there.”

And that’s one of the major benefits for many patients: They can be treated in their own community hospital instead of being transferred to Toledo. Pam Jensen, president, Fremont Memorial Hospital, said this can have emotional benefits for patients and their families, too.

“It’s so that the families don’t have that added stress,” she said. “They’re already stressed; their loved one’s in the hospital. It’s so that we don’t put that added stress on them of having to travel and then having to navigate the city of Toledo, the campus of Toledo Hospital, which is quite a bit larger than here.

In Robert’s case, he was diagnosed with a TIA, or mini-stroke. After some testing and medication, he was able to go home the next day, miss less work and, most importantly, feel better sooner.

“This advancement is just wonderful,” said Margraf. “We can keep patients in smaller facilities, and they don’t have to travel. They can just stay right here and we have access to state-of-the-art physicians.”

“The stuff that they have here and what they do here now for a small hospital in Fremont, I never expected that at all,” said Kerlin.

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