Rural Trauma? There's an App for That

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I don't get how this is an EMTALA violation.  The patient was discharged
with an emergency medical condition from the remote site?  

And either way, how is this different from having transfer/not conversations
via conventional telephony?

Our major problem with CMS is their credentialing restrictions, which are at
least equally baffling: in order to give advice over a camera, the
consultant must have PRIVILEGES at the remote site.  For us, that's 20-plus
potential sites, times 6 providers on the trauma service alone.  Thankfully,
there's talk that this will be revisited soon.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of McSwain, Norman E
Sent: Thursday, March 17, 2011 1:51 PM
To: Trauma-List [TRAUMA.ORG]
Subject: RE: Rural Trauma? There's an App for That

I assumed from what you said that the patient was not transferred, was
properly treated in the primary facility and did well. We were recently
cited by CMS on a similar patient for EMTALA violation. Specialist was
the consultant on our end of the phone. The primary physician agreed
with the plan but none-the-less the citation occurred.

 

Norman

Norman McSwain MD, FACS

Professor, Tulane School of Medicine

Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO 

norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

504 988 5111

 

From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Pret Bjorn
Sent: Thursday, March 17, 2011 11:46 AM
To: 'Trauma-List [TRAUMA.ORG]'
Subject: Rural Trauma? There's an App for That

 

Just wanted to let the world know that as of this week, Eastern Maine
Medical Center has begun offering carefully controlled remote teletrauma
consultations via Skype(r).  We distributed a bunch of iPod Touches(r)
to wifi-equipped rural ED's, and early this morning performed our first
bona fide consult.  Providers at either end expressed overwhelming
satisfaction with the process. It continues to impress me how the
effects of blindness are underestimated until one can SEE.

 

We've had tremendous success with other (more sophisticated)
telecommunications systems, and will doubtless continue to use them
regularly; but there is no doubt that our iPods offer improved
affordability, accessibility, and ease of use.

 

In this morning's case, a victim of facial injury was assessed and
triaged for transfer and/or OMFS follow-up (there aren't enough on-call
maxillofacial surgeons in New England to play a decent game of Hold
'Em).  Of course our trauma surgeon was excited to be trying the new
tools, and the remote ED provider was immensely satisfied.  Then the
remote device was handed to the patient's mother, who was thrilled  to
be able to talk to her kid's consultant, face to face and in real time,
from the depths of rural Maine.

 

The patient?  "Jeez, Mom, it's just Skype.  We [kids] use it all the
time."

 

We'll collect up some cases and publish ASAP.  

 

Pret Bjorn, RN

Bangor, ME USA

 

Eastern Maine Medical Center: one of the nation's most wired hospitals.

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