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Embracing Telemedicine: Piggott Community Hospital Serving as National Model

The following article is from Arkansas Hospitals magazine, a custom publication of Vowell, Inc., which also produces Arkansas Money & Politics.

by Nancy Robertson, Senior Editor
Photos courtesy of Alex Gookin, AG Video Services

That a rural Northeast Arkansas Critical Access Hospital is a national leader in the practice of telemedicine may, on its face, seem surprising.

That the hospital is Piggott Community Hospital, long known for its strategy of connecting with a wide variety of partners to increase health care access for its patients, removes the element of surprise. In fact, “of course!” is a predicted response.

Piggott Community Hospital (PCH) is guided by its longtime Executive Director James Magee, a leader who believes in seeking patient care access through any and all avenues.

“As a community-owned hospital, we are not limited to any one system in the partnerships we can generate,” Magee says. “So to benefit our patients, we participate in as many programs as possible – whether conventional or unconventional and across a broad spectrum – to best meet the needs of the patients we serve.”

Initial logic for the development of the Telemedicine Program was that many of the area’s elderly and financially challenged did not have the capability and/or resources to travel to distant locations for physician specialty care. “Telemedicine was the obvious mechanism to dramatically increase access to specialty care,” Magee says.

There are many avenues of telemedicine being employed at PCH. For example, the hospital is a beta site for a Tele-Emergency program with UAMS, whereby an emergency department physician at PCH can connect with a Board-Certified Emergency Medicine physician for a consult on a complex care issue.

But it is one program, especially, that moves the hospital into the national limelight.

That is the collaboration with Innovator Health and the use of its remarkable telemedicine delivery system, “the Rounder,” which allows patients to build incredibly close relationships with their physicians – even those remotely located.

Anatomy of the Rounder

The Rounder is a more than six-foot tall apparatus that looks like a 55-inch television, upended to vertical, and made portable by putting it on wheels. It’s the brainchild of Dr. Darren Sommer, DO, MBA, MPH, a true believer in the necessity of building doctor/patient relationships even absent the face-to-face experience.

“Our goal is to deliver telemedicine experiences that are so rich and natural that neither the patient nor their caregiver ever sees the distance that separates them,” he says.

The Rounder functions as a life-sized connector between physicians and their patients. Besides the screen that brings patient and physician together, the Rounder has a nurse-operated workstation, which includes HIPAA-compliant laptop and video/conversational connections, as well as exam equipment ranging from scopes to cameras, to help the physician with the diagnostic process.

Designed by Dr. Sommer, the Rounder employs technology that seems impossible – it provides real eye contact between patient and physician through a 3D experience, which makes the building of the all-important relationship between patient and caregiver a thoroughly engaging process.

It changes the world of the more common small, impersonal, cart-based telemedicine communications – once the epitome of high-tech telemedicine – to a truly life-sized and personal, immediate doctor-patient experience.

PCH Executive Director James Magee in Piggott, Arkansas, consults with Dr. Darren Sommer, physician-inventor of the Rounder, in Englewood, Ohio, using Dr. Sommer’s invention.

A “Rounder” Collaborative Is Born

Magee was an early adopter and beta-tester of the Rounder on behalf of PCH’s patients. He was also, cooperating with Dr. Shane Speights and St. Bernards Health System, instrumental in bringing the technology to the new osteopathic school of medicine located on the campus of Arkansas State University in Jonesboro.

“Dr. Speights, who is now the dean of the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) at Arkansas State, has a long practicing history at St. Bernards,” Sommer says. “St. Bernards helped purchase the Rounder in use at PCH, and is using its physicians to staff it.” The cooperation between the three entities (PCH, St. Bernards and NYITCOM at Arkansas State) is integral to northeast Arkansas’s becoming a national leader in this leap forward in telemedicine utilization.

“It would be hard to find a rural hospital more innovative and aggressive in the adoption of telemedicine than PCH,” says Dr. Sommer. “We are grateful to Mr. Magee for working with St. Bernards and Dr. Speights as we explore a connection for helping today’s medical students become comfortable with the practice of telemedicine.” (Please see the article about Telemedicine Education at NYITCOM-ASU later in this issue of Arkansas Hospitals.)

With the Rounder, it’s as if your doctor is right there in the room.

Dr. Sommer works with NYITCOM-ASU students, beginning in their very first year of medical school, in building the all-important physician/patient relationship through and by use of telemedicine technologies. His title? Professor of Telemedicine.

Essential Connections for Rural Patients

“Telemedicine is an extension of face-to-face medical practice,” Magee says. “At PCH and in our rural health clinics in Rector and Campbell, we also advocate for our patients to see their telemedicine physicians in person when the doctors make their regularly scheduled trips to our various locations.”
What are some of the other many telemedicine opportunities for patients in the Northeast Arkansas/Southeast Missouri region served by PCH?
• Cardiology/Heart Clinic visits through St. Bernards telemedicine;
• Dermatology visits through a physician located in Searcy/Jonesboro;
• Sleep Study services through pulmonologists at St. Bernards;
• Gastroenterology consults through a physician located in Cape Girardeau, Missouri;
• AR SAVES stroke consults through UAMS;
• Tele-ICU (e-ICU) consults through Baptist Health;
• Mental health consults through the Mid-South Health System;
• And coming soon: ear, nose and throat services through St. Bernards.

“One of our goals is to make telemedicine services available in our rural health clinics,” Magee says. “We are also in discussion with our large home health, assisted living and skilled nursing care locations on ways to employ telehealth – and the Rounder – for the care of these patients.”

Ben Bloom, principle with Affinity Healthcare, Inc., a healthcare management firm that has worked with PCH for more than 15 years, is helping Magee continue expanding the hospital’s telemedicine reach.

“There are a lot of health care venues that talk about a commitment to telemedicine,” he says, “but Piggott Community Hospital demonstrates its commitment. Both from the top down (leadership commitment) and the bottom up (professional staff buy-in at all levels), PCH is dedicated to providing telemedicine excellence for its patients.”

A perhaps unanticipated challenge faced by PCH in its desire to increase its telemedicine outreach is not in the areas of technology or patient satisfaction; the challenge is often in getting physicians comfortable with the practice.

“If we can get our specialty physicians (located in other locations who travel to Piggott for outpatient services) to try telemedicine, they most often report liking and appreciating it,” Magee says. “We will never eliminate the needed face-to-face physician visits, but we find we can reduce the number of in-person encounters greatly when our specialists embrace telemedicine.”

Physicians typically agree to use telemedicine when they see the positive impact it has on their patients.

It’s easy to see how telemedicine can be a boon to rural health care, bringing specialists into reach for patients in remotely located and underserved areas. And PCH’s examples of how to utilize and encourage participation in telemedicine are already bearing fruit in neighboring states. Besides the use of PCH telemedicine programs by patients located over the state line in Missouri, two hospitals in Mississippi are replicating PCH’s extensive and wide-ranging telemedicine practices after visiting the hospital for a close-up view of how the programs are woven together.

PCH is also in discussion with long-term care facilities in the Northeast Arkansas region to see how the Rounder could be employed to better serve individual patients in these organizations.

“We can see how patients can benefit from having the Rounder brought to their rooms and having a telemedical physician visit and a diagnosis be made on the spot, without having to bring these fragile patients out into the weather or having them endure waits in the ER or clinic,” Magee says.

“The most important thing telemedicine, in all its forms, brings to our patients is increased access to health care and local access to specialists they would otherwise only see by traveling long distances,” Magee adds. “We’re proud that PCH is seen as being far ahead of the curve in its multi-disciplinary approach to telemedicine, and for setting the bar for what’s possible for rural and Critical Access Hospitals across the nation.”

How The Rounder Came To Be

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