Nation’s First Telemedicine Program for Hand Trauma Established

By Ben Boulden

 

Jan. 27, 2014 | Patients with hand injuries now have access to the nation’s first hand trauma telemedicine program established this month by the University of Arkansas for Medical Sciences (UAMS), the Arkansas Trauma Communications Center and the Arkansas Department of Health.

Through the Hand Telemedicine Program, patients and their physicians in hospitals throughout Arkansas can consult in real time with hand trauma surgeons and specialists via a high-definition broadband video connection provided through Arkansas e-Link.

The real-time telemedicine consultations will provide the best possible treatment for hand injuries. The surgeons, using an iPad or other mobile device, will connect to local doctors and hospitals that use telemedicine equipment called e-Link carts. The equipment was distributed to health care providers around the state by Arkansas e-Link using a $102 million federal grant from the Broadband Technology Opportunities Program (BTOP) received by UAMS Center for Distance Health and partners to boost broadband connections across the state.

The UAMS Center for Distance Health provides technical support and quality management to the program, said Terri Imus, R.N., trauma telemedicine coordinator with the Center for Distance Health, who played a key part in organizing the new program.

Todd Maxson, M.D., UAMS professor of pediatric surgery, Arkansas Children’s Hospital trauma director and Health Department trauma medical consultant, said hand injuries affect people’s livelihood, and treatment is often long and difficult.

“Providing timely, expert care is paramount to a successful recovery,” Maxson said. “The Center for Distance Health’s Hand Telemedicine Program gives patients and physicians immediate access to hand experts.”

He said that previously, hand patients were transferred at significant cost and inconvenience from a clinic or hospital in their hometown even when they may not have required further treatment. This program will allow providers to decide which patients need to be transferred.

Jan. 27, 2014 | The Arkansas Trauma Communications Center has organized a group of hand surgeons to be on call to evaluate injuries through real-time video. UAMS Medical Center is the only provider in the state that performs hand reattachment surgery.

UAMS surgeons Theresa Wyrick, M.D., and John Stephenson, M.D., are part of the on-call team, including two more physicians in Central Arkansas and three in northwest Arkansas. Wyrick said the need for hand specialists is not unique to Arkansas.

“Most states struggle with taking care of hand trauma injuries for many of the same reasons,” she said. “Through this partnership, hand specialists at UAMS and in private practice have come together to help provide better care for these injuries in the people of our state. The major benefit is to our citizens who are farmers, carpenters, craftsmen, and industrial workers who do physical work with their hands. Other states are going to want to know how we accomplished this so they can model their own systems after it.”

Under the program, when a patient goes to a local hospital with a hand injury, the emergency department staff connects to a virtual hand trauma room along with staff at the Arkansas Trauma Communications Center and the hand surgeon. The hand surgeon evaluates the patient’s injury and makes recommendations for treatment. If the hand surgeon recommends the patient be transported to a different hospital for further treatment, ATCC coordinates the transfer, confirming that the right specialist is available without delay.

“The trauma system is only three years old,” said Jeff Tabor, Arkansas Trauma Communications Center program director. “We have made progress in leaps and bounds in securing acceptance for trauma patients, but we always struggle with hand trauma. We find appropriate care for the average trauma patient in six-and-a-half minutes. With hand patients, it can take hours due to the limited number of hospitals providing an on-call hand specialist in the state. The physicians in the call group are working with us to identify the significant hand emergencies and to provide timely care to all hand trauma patients.”