“The very first time we turned it on, the patient had a great experience,” said Dr. Trey Dobson, a specialist in emergency medicine and chief medical officer at SVMC.
On Wednesday, Dobson helped demonstrate the hospital’s new telemedicine system, which has been in operation in his department for the past month.
He and others at the local hospital are working with colleagues based at Dartmouth-Hitchcock’s Center for Connected Health in Lebanon, New Hampshire, employing high-definition, two-way video conferencing equipment that allows consultation and cooperative treatment of patients across the miles.
“As a physician, I can have a dialogue with the physician as we take care of a patient,” Dobson said. “Or they are just there observing. And they can zoom in on the patient — they can call out things if we are busy.”
The assistance goes beyond long-distance consultation, he said, adding, “They do things like they take notes; they document our medical records so our nurses don’t have to be typing on the computer; they can be at the bedside taking care of patients.”
When personnel leave the room, he said, the patient can ask the remote team questions or seek an explanation of the ongoing care. “They are really good at engaging with the patient,” Dobson said.
Beyond receiving input from board-certified, experienced physicians, Dobson said the telemedicine teams in New Hampshire can “investigate things for me,” or research questions that otherwise would take him away from a patient in the ER. They can make phone calls to arrange for a medical transfer to a larger hospital, schedule an X-ray at SVMC and help in documenting the treatment given, allowing the on-scene physicians and nurses to focus more on the patient.
The telemedicine option, one of several partnerships between the Bennington hospital and Dartmouth-Hitchcock, so far is available in the emergency department and for neurological patient consultations throughout the hospital.
But Thomas Dee, president and CEO of Southwestern Vermont Health Care, said the feature will be expanded to other departments and other SVHC facilities.
The neurology telemedicine equipment, which is portable and can be moved on a cart to any room at SVMC, went into use in April, Dobson said. It allows 24-hour access to a board-certified neurologist for stroke or other patients.
Dee said the Intensive Care Unit will be linked through the system to Dartmouth-Hitchcock by the fall, and a telemedicine link is planned for SVHC’s Northshire Medical Center in Manchester by late summer.
Telemedicine is a rapidly growing part of health care nationwide and will play a growing role over time in operations at the Bennington-based health system, Dee said. Telemedicine will be incorporated into plans for expanded emergency care and surgical facilities at the local hospital, he added.
The two-person Dartmouth-Hitchcock telemedicine teams are available during the daytime, Dobson said. At night the center operates in partnership with national telehealth leader Avera Health, which serves more than 600 emergency departments, or through Specialist on Call, which uses doctors in locations nationwide.
In the ER, Dobson said, the system initially is used primarily for patients in significant distress who might need resuscitation or other emergency procedures — representing about 5 percent of the ER patients the medical center sees annually.
He said those working on patients in Bennington are becoming accustomed to talking to the team on the screen above them, usually without looking to the screen as they did at first. And ER personnel have already reported an instance when someone in Lebanon was the first to notice a troubling reading on a monitor in Bennington, allowing for the fastest possible response.
Dee said telemedicine can be especially beneficial to a younger physician or nurse working at an outpatient facility, as they are able to treat patients alongside experienced doctors.
The system must be activated by personnel at the patient’s bedside, Dobson said, and the patient can decline the service if they choose. No recordings are made of the treatment, he said.
Participating on Wednesday from New Hampshire were Dr. Kevin Curtis, medical director of the Center for Telehealth at Dartmouth-Hitchcock; Dr. Victoria Martin, an emergency physician; and Katharine Moore, an emergency nurse.
They said all of the team members also work at least part time elsewhere at Dartmouth-Hitchcock, maintaining the direct care experience as well.
“It’s a whole new challenge to the job,” Martin said of participating in emergency treatment from a distance.
She said the experience also is enjoyable, “to be able to have a sort of bird’s eye view of the whole room and of the scene that’s going on, and being able to think through the whole thing when you are not tied up with procedure. … You have the opportunity to really look at the case in a broader sense.”
The Dartmouth-Hitchcock center is working remotely with a total of eight hospitals, Curtis said, adding that team members can learn from the collaboration as well as assist — being able to view treatment in a variety of hospitals and settings. “It is also educational for us,” he said.
Dee added, ““The future is here, and I think it’s a great advance.”