Birth of Telemedicine at Connecticut Children’s
One of the big advantages of telemedicine is the fact that it lets caregivers see the child in context, in their home. This circumstance provides a great deal of insight into the factors that affect child health.
Joyce is one of the founding principals at DanaherLagnese law firm who has specialized in medical malpractice for more than 30 years. She’s worked with Connecticut Children’s since its founding, and with its predecessor, Newington Children’s Hospital.
As part of her job, Joyce reads all of the major medical journals, and a few years ago, in the course of that reading, she kept coming across references to telemedicine. In 2015, she proposed making a presentation on the subject to the medical staff at Connecticut Children’s. “I knew it was out there,” she says, “but it hadn’t gained traction in a medical sense. Most hospitals had telemedicine in some form, but it wasn’t for mainstream activity.”
Part of Joyce’s presentation was focused on the example of the Children’s Medical Center of Dallas, in Texas, which was operating a very large and successful telemedicine program. As it happened, one of the people in the audience was James Moore, MD, PhD, who designed the Dallas program and who had just been hired to head Connecticut Children’s Neonatal Intensive Care Unit (NICU). The two of them connected, and the seeds were planted for a new telemedicine program.
With Joyce’s philanthropic backing, the hospital purchased two telemedicine carts. These complex and sophisticated carts allowed specialists at Connecticut Children’s to closely examine patients at a distant hospital and advise local doctors on how to perform specialized procedures. These remain tremendous tools, but when COVID-19 happened, the nature of telemedicine had to evolve—and it had to happen quickly.
An Evolving Technology
With telemedicine, families can save hours of travel time and children can stay in a comfortable, safe environment.
Because of the COVID-19 pandemic, people couldn’t casually go to a local clinic to be connected to a doctor in Hartford on a specialized machine; they were sheltering in place at home. And there were far too many people to serve with two available carts. The solution was to add smartphones, tablets and computers to the medical toolbox.
Within the space of a month, telemedicine became common in every single corner of the hospital and across all of Connecticut Children’s 39 locations. The current projection is that even after the pandemic subsides, telemedicine will account for as much as 40 percent of patient visits.
“The clinic-to-clinic video visits we have with the carts were and are important,” says Jeff Sargent, the Director of Virtual Health at Connecticut Children’s. “They’re in line with our expansion strategy. We now have outposts, and we need to connect those outposts to the mothership. We do that through those clinic-to-clinic communications. So, an advanced-practice nurse in Danbury will talk to a specialist in Hartford by video, we’ll speak with patients in our South Hadley, Massachusetts, office, and so forth. But this new approach to telemedicine lets us meet patients where they are, which is on their phone.”
For the parents, the process is extremely simple. They use an app on their phone that allows them to set up the appointment, and when, when the appointment time arrives, the doctor calls the parents and begins the video visit.
Putting the “Connect” in Connecticut
James Moore, MD, Division Head, Neonatal Intensive Care Unit and Vice President of Clinical Network Development, uses a telemedicine cart to speak with donor Joyce Lagnese, who worked with Dr. Moore to establish Connecticut Children’s telemedicine program.
The telemedicine program at Connecticut Children’s has been growing so quickly because telemedicine, and the broader concept of virtual health, offers a large number of benefits—benefits that are above and beyond the immediate demands of COVID-19.
One is convenience. “Until now,” Joyce says, “a doctor appointment meant you get in the car, drive there and find a place to park, go to the office and get in the elevator and so forth. So, a 15-minute visit takes up two-and-a-half hours of time.
Then there are children who are so sick that the trip to the hospital itself poses health risks. That trip should only be taken if it’s absolutely necessary, and telemedicine helps reduce the number of unnecessary trips. That benefit doesn’t just apply to at-risk children. Telemedicine visits serve as a triage tool more generally, helping care providers determine which children really do need the hospital’s facilities and which can be treated effectively in their homes.
With telemedicine, if a child lives in Westport—or Los Angeles—he or she can have the specialist come to him or her. And even if the video exam reveals a condition that needs physical intervention, the parent can take the child to a local hospital, and the Connecticut Children’s specialist can use a video conference to help a local doctor provide appropriate care.