Shore Re­gional Health ex­pands tele­health ser­vices

Record Observer - - News - By JOSH BOLLINGER jbollinger@star­dem.com

EAS­TON — Imag­ine be­ing a pa­tient who lives on the MidShore and doesn’t have to drive to Bal­ti­more to see their pal­lia­tive care or psy­chi­a­try med­i­cal spe­cial­ist.

That will soon be an op­tion for pa­tients, as Univer­sity of Mary­land Shore Re­gional Health is ex­pand­ing its tele­health ser­vices in Kent and Queen Anne’s coun­ties in an ef­fort to try to close ser­vice gaps in a ru­ral area like the Mid-Shore.

The med­i­cal sys­tem re­ceived a $75,000 grant from the Mary­land Health Care Com­mis­sion for the project, which is specif­i­cally de­signed to ex­pand ac­cess to ser­vices and ex­perts in pal­lia­tive care and psy­chi­a­try for pa­tients in Queen Anne’s and Kent coun­ties, two coun­ties where tele­health ser­vices are lack­ing.

“The MDCC grant en­ables UM Shore Re­gional Health to ap­ply state-of-the-art tele­health tech­nol­ogy to close dif­fi­cult gaps in ru­ral health­care,” said Dr. Wil­liam Huffner, chief med­i­cal of­fi­cer and senior vice pres­i­dent of med­i­cal affairs for Shore Re­gional Health.

Tele­health al­lows pa­tients to see doc­tors us­ing telecom­mu­ni­ca­tions and re­lated tech­nolo­gies, like video con­fer­enc­ing and the use of re­mote ex­am­i­na­tion tools. It aims to re­duce hos­pi­tal emer­gency de­part­ment vis­its and in­pa­tient ad­mis­sions and read­mis­sions, while im­prov­ing ac­cess to care and pro­vid­ing cost sav­ings to pa­tients, ac­cord­ing to Shore Re­gional Health.

Ac­cord­ing to Shore Re­gional Health, a sig­nif­i­cant gap in ru­ral health care is caused by the na­tion­wide short­age of skilled health care providers in key med­i­cal spe­cial­ties. Pal­lia­tive care and psy­chi­a­try are two are­nas in which the scarcity of providers is a se­ri­ous is­sue, es­pe­cially in ru­ral ar­eas, ac­cord­ing to the health sys­tem.

Shore Re­gional Health plans to ex­pand psy­chi­a­try tele­health ser­vices to Shore Emer­gency Cen­ter at Queen­stown and Shore Med­i­cal Cen­ter at Ch­ester­town, which are cur­rently with­out ded­i­cated on­site be­hav­ioral health ser­vices and re­sources. It also will ex­pand pal­lia­tive care tele­health ser­vices to the Ch­ester­town hos­pi­tal, and to the Shore Nurs­ing and Re­ha­bil­i­ta­tion Cen­ter at Ch­ester­town.

This is not Shore Re­gional Health’s first project with tele­health. The med­i­cal sys­tem cur­rently has tele­health pro­grams run­ning for pe­di­atric and in­ten­sive care pa­tients, said Dr. Marc Zubrow, vice pres­i­dent of telemedicine and med­i­cal di­rec­tor of eCare for the Univer­sity of Mary­land Med­i­cal Sys­tem

The tele­health ICU pro­gram has been run­ning the long­est, for about three years. Zubrow said it is a “very so­phis­ti­cated, in­te­grated sys­tem” that al­lows for “pretty much ev­ery­thing that we could see at the bed­side, we could see at the teleICU.”

“We know that with the teleICU sup­port, the num­ber of trans­fers out of the three hos­pi­tals at Shore Health has di­min­ished con­sid­er­ably, with im­prove­ments in their over­all mor­tal­ity, their hos­pi­tal length of stay, their ICU length of stay, their re­duc­tions in com­pli­ca­tions,” Zubrow said.

He said tele­health is very ap­pli­ca­ble for the “not-so-sick” pa­tients, or the pa­tients in the emer­gency room who need an opin­ion from an ex­pert not on site be­fore be­ing sent home. But, Zubrow said that’s “not to say we wouldn’t use it on an acutely, crit­i­cally ill” pa­tient.

“Be­fore we had got­ten into telemedicine, of­ten times the (pa­tient) would be sent up to Bal­ti­more for a sec- ond opin­ion and, you know, it would take the whole day and the same thing would be ac­com­plished,” Zubrow said. “Whereas this way, in a 10-minute telemedicine re­fer­ral and dis­cus­sion, we could take care of that.”

Huffner said that with any new tech­nol­ogy, it is im­por­tant to study how it is used in a way that will al­low the best prac­tices to de­velop.

“This grant will help us en­sure that we make the best use of tele­health by ad­dress­ing a num­ber of ques­tions, such as: What fac­tors about a pa­tient’s con­di­tion make the use of tele­health ideal or less than ideal? What are the bound­aries of tele­health, in terms of pa­tient tol­er­ance and sat­is­fac­tion?” Huffner said.

One chal­lenge Shore Re­gion- al Health has sought to ad­dress with pal­lia­tive care is to in­clude not only pa­tients, but also key fam­ily mem­bers in dis­cus­sions so that every­one un­der­stands the care op­tions.

“Tele­health may prove very suc­cess­ful in achiev­ing that goal by en­abling the pa­tient, the provider and fam­ily mem­bers, in­clud­ing those at var­ied re­mote lo­ca­tions, to par­tic­i­pate in a three-way tele­health dis­cus­sion,” Huffner said.

An­napo­lis Al­lergy and Asthma opened its Cen­tre­ville lo­ca­tion at 227 North Liberty Street in Novem­ber. Shore Health is look­ing at of­fer­ing pal­lia­tive care and psy­chi­a­try there via tele­health.

PHOTO BY HAN­NAH COMBS

Shore Emer­gency Cen­ter at Queen­stown pro­vides emer­gency ser­vices to res­i­dents of Queen Anne’s County and sur­round­ing ar­eas. The cen­ter has served more than 15,000 pa­tients since open­ing five years ago.

PHOTO BY DANIEL DIVILIO

Univer­sity of Mary­land Shore Re­gional Health of­fi­cials are work­ing to bring ex­panded telemedicine ser­vices to Shore Med­i­cal Cen­ter at Ch­ester­town, pic­tured above. They also are work­ing to ex­pand ser­vices in Queen Anne’s County.

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