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A new program led by UNMH and a local company is helping doctors save lives from afar.
Howard Yonas, a professor and chairperson of neurosurgery at UNM’s School of Medicine, said the hospital has teamed up with Albuquerque-based Net Medical Xpress to create a telemedicine program that would allow neurological specialists to remotely assess patients in rural hospitals around the state.
The telemedicine program uses the software package XR-Express, which uses webcams for communication online. From their computers, qualified doctors and specialists can sign into the software and view CT scans and examine patients.
But the technology used for the program differs from simpler webcam programs, Net Medical CEO Richard Govatski said.
“When you do telemedicine, you have to have the right technical expertise in order for all of the components to come into place,” he said. “You can’t just … go to Best Buy and buy a camera and set up a Skype account and say, ‘I’m going to make it work.’”
For example, Govatski said strict government regulations regarding doctor-patient confidentiality require them to use the right technological approach.
“You could use a Skype camera like you use at home,” he said. “But what happens with the security?”
Govatski said Net Medical provides the security people need to perform consultations over the Internet. He said the firm has a “whole infrastructure” to protect patient information.
Govatski said the telemedicine program provides information doctors can use to diagnose patients from miles away.
“The patient is located 300 miles away. How do we get Dr. Yonas to be able to see that information?” he said. “That’s part of the technology.”
Govatski said UNMH doctors can also add notes on the patient’s condition and give recommendations about what the host hospital should do with the patient.
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It took years to get to this point, Govatski said.
“We’ve been working with Dr. Yonas since 2005,” he said. “It was a long process because technology wasn’t available. Still, technology is not available in some instances.”
Yonas said the program is beneficial for the state because New Mexico’s large geographic size prevents some people from getting the immediate medical attention they need. He said clinical problems need to be handled very quickly.
“The first few hours are critical to getting a good outcome with few complications,” Yonas said. “The longer the time it takes to make that decision, the worse the outcome.”
For example, a doctor attending to a patient who might have had a stroke would have to decide whether to administer a tissue plasminogen activator, a drug that breaks down blood clots, Yonas said. But after about three hours, the chances of effective treatment with tPA drop drastically.
Yonas said doctors consider many variables before deciding whether to give tPA to a patient. He said tPA can cause hemorrhages if not used correctly.
“You’ve got to make the right call with the right patient,” he said. “You have to worry about all their drugs, their blood pressure and some other variables … tPA could hurt somebody if you give it to the wrong person.”
However, stroke specialists in the state are in short supply, and many rural doctors do not feel comfortable deciding whether to administer tPA, he said. So patients often have to be airlifted to UNM Hospital for examination, which costs them time and money.
The new telemedicine program would allow doctors to, essentially, be present in emergency room with patients, Yonas said.
Govatski said the telemedicine program is a major advancement in medical technology.
“It’s 21st-century medicine like you’ve never ever seen before,” he said.
