Telemedicine brings critical care expertise to small hospitals

David Hotchkin, M.D. 
Medical director
Providence Telecritical Care

The scenario plays out in countless rural emergency departments around the country: A patient presents with a serious illness that requires specialized expertise to treat. Does the hospital have the proper resources, or does the patient need to be transferred to a facility that might be hundreds of miles away? While medically necessary in many situations, transfers create a myriad of challenges, including separating the patient from family and friends.

In response, we’ve launched Providence Telecritical Care, a 24-hour consultation service for physicians and patients in outlying communities. Using two-way video, board-certified critical care physicians at Providence Portland and Providence St. Vincent medical centers offer expert advice to providers whose patients are too ill to be safely transported or who simply need more clinical expertise.

Telecritical care employs the same kind of “remote presence” video technology that is used in telestroke.

How telecritical care works
• Requests for consultations are initiated by a single phone call to an 800 number.
• If telecritical care is advised, an intensivist in Portland will examine the patient via videobased equipment provided by InTouch Health. The local hospital also can upload diagnostic images and other supporting documentation.
• The intensivist examines the patient and speaks directly with the attending providers and family to determine the best treatment plan.
• After the consultation, the intensivist provides a full consultation note that includes initial and ongoing recommendations.

If the team decides that transfer is appropriate, the intensivist can help to prepare the patient. Often, the consulting physician also is the admitting physician.

This service is a partnership between Providence Health & Services and The Oregon Clinic’s Pulmonary, Critical Care and Sleep Medicine Division and Oregon Pulmonary Associates. To learn more, call 503-893-7415.

Dr. Hotchkin practices with The Oregon Clinic’s Pulmonary, Critical Care and Sleep Medicine Division.