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Study Proves Telemedicine’s Value in Coma Assessment and Care

A Mayo Clinic study finds that a virtual care platform is just as effective as a bedside doctor in assessing comatose patients and planning their care. It's the latest in a series of studies proving the value of digital health in the ICU

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- Mayo Clinic Researchers are adding to the literature supporting telemedicine in the ICU with a study that indicates digital health can be used to monitor comatose patients as well as having someone at the bedside.

A study conducted by researchers at the May Clinic in Arizona and published in the January edition of Telemedicine and e-Health indicates doctors assessing comatose patients by telemedicine performed just as well on two common assessment tests as those at the bedside.

"This is good news in many ways," Amelia Adcock, MD, a neurologist the Mayo Clinic College of Medicine at West Virginia University and first author of the study, said in a Mayo Clinic press release. "We use telemedicine frequently when evaluating acute stroke patients. This study suggests yet another way telemedicine can enhance patient care. There is a shortage of intensive care unit providers and facilities with round-the-clock patient coverage. Telemedicine can provide a way to ameliorate this shortage and improve early evaluation of critically ill patients."

Led by Bart Demaerschalk, MD, a neurologist at the Mayo Clinic Hospital in Phoenix, the research team analyzed more than a dozen clinicians who monitored some 100 comatose patients over 15 months. The patients were assessed using either the Glasgow Coma Scale (GCS) or the Full Outline of UnResponsiveness (FOUR) score scale, or both.

By establishing a telemedicine platform in the ICU, patients with a decreased level of consciousness or those in a coma can be triaged and assigned a care management plan more quickly, Demaerschalk wrote in the study’s abstract.

Demaerschalk, director of the Mayo Clinic’s telestroke and teleneurology program, conducted one of the nation’s first studies on the use of telemedicine in stroke treatment in 2007. In 2013, as the director of the Mayo Clinic’s telestroke and teleneurology program, he helped launch Mayo’s Center for Connected Care, designed to “provide virtual care to patients regionally, within states that are historically Mayo Clinic territories, but also nationally and globally.”

His latest study adds to a growing list of uses for telemedicine – or virtual care -  in critical care environments, and builds on recent studies that proven the technology’s value for large health systems supporting the platform as well as rural and remote hospitals using it.

"Virtual care will positively impact our quality, cost and the patient experience across our health system and beyond because it will allow us to identify and meet patients' needs earlier," Craig Hillemeier, MD, CEO of Penn State Health, said in 2016 when Milton S. Hershey Medical Center became part of a hub-and-spoke telemedicine network organized by Mercy Virtual in St. Louis. "Having this 'second set of eyes' on our most ill and injured patients will identify and meet patients' needs faster, often presenting simpler and less intensive solutions. In the long term, this type of partnership can help address the nursing and physician specialist shortages across the country."

Mercy Virtual, the nation’s first “hospital without beds,” is at the center of a number of telemedicine networks overseeing intensive care units in smaller hospitals and health networks. Its president, Randall S. Moore, MD, MBA, sees the platform as a model for critical care services across the country.

"Virtual care will be critical to the future of healthcare," Moore said. "The healthcare world we know today is no longer the health care of the future. Virtual care overcomes the barriers that prevent us from delivering the best care to our patients.”

"Every system in the U.S. brings specific expertise – be it research, intensive care or training clinicians – and by coming together, we believe we can bring that expertise to more people - faster. For patients, it means they get the best care whether they are in a hospital or a clinic or at home, or even away on vacation. It brings care to them where and when they need it."

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