The emergency department at Mt. Ascutney Hospital and Health Center, a 25-bed critical access hospital in Windsor, Vt., is staffed by physician assistants, with an emergency physician on backup. But if they need more immediate help, the push of a button will summon emergency medicine specialists — from South Dakota.
A two-way, high-definition video/audio link connects two Mt. Ascutney Hospital emergency bays to Sioux Falls, S.D.-based Avera Health, a leading provider of tele-emergency services, through an arrangement with the Dartmouth-Hitchcock Center for Telehealth. Mt. Ascutney Hospital is an affiliate of Dartmouth-Hitchcock.
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Board-certified emergency physicians support the Mt. Ascutney Hospital physician assistants while Avera’s ED nurses work on documentation, place orders and arrange transport, if needed.
“This allows us to focus our attention on the patient,” says Patti Strohla, R.N., director of clinical transformation at Mt. Ascutney Hospital. “Our telehealth partners at Avera will initiate the contact with a helicopter team, get them in the air and provide them with all the information, so we can continue our clinical care.”
Emergency telehealth, which launched in January, is one of three telemedicine applications improving care in rural Vermont. Mt. Ascutney Hospital recently started using telepharmacy services for evening and weekend support and expects to add teleneurology services later this year followed by telestroke.
Those are the most recent in a series of technology investments, including replacing three disparate electronic health record systems and a lot of paper charts with a single EHR that connects all inpatient and outpatient venues.
“Much of our capital budget over the last six years has been geared toward new information technology to improve our processes,” says Kevin Donovan, president and CEO at Mt. Ascutney Hospital until June, when he took the same position at LRGHealthcare in Laconia, N.H. “We have a limited budget, so we have to prioritize those that enhance the patient experience from a care perspective and a quality perspective.” For example, Mt. Ascutney Hospital uses technology to help military veterans stay close to home. Many veterans are served by its rehabilitation center, but the Veterans Administration often requires them to be transported to a VA hospital for evaluation.
“We spend a lot of time putting them in an ambulance and driving them up there, which takes time away from their therapy,” Strohla says. “We are working with a VA hospital to use iPads to let (VA clinicians) watch patients walk to help prepare them for prosthetics. We look forward to expanding those capabilities.”