Last year was the twentieth anniversary of the Institute for Digital Health & Innovation’s (IDHI) High-Risk Pregnancy Program (HRPP) at the University of Arkansas for Medical Sciences. In the decades of its existence, the HRPP has built a model of success so robust that leaders from other states and other nations have made site visits to Arkansas with hopes of replicating this type of maternal health in their own communities.

“When the High-Risk Pregnancy Program first started out, online education was limited, resources were few and far between, and reliable, high-speed, internet access was scarce in several parts of the state,” says Joseph Sanford, MD, director for IDHI. “Today, with the growth of infrastructure and technology, we have capabilities of reach and care that covers the entire state and beyond.”

“Our High-Risk Pregnancy Program leverages advanced technology to provide comprehensive support and medical expertise,” says Rosalyn Perkins, MNSc, APRN, WHNP-BC, APRN Coordinator and High-Risk Pregnancy Program Director, “ensuring the best possible outcomes for both mother and baby, particularly in complicated pregnancies.”

 

Find out more about the High-Risk Pregnancy Program:

Learn More

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Connecting Across Professions (CAP) is a teleconference that focuses on chronic disease, healthcare trends, and interprofessional collaboration. Healthcare professionals can stay current on a variety of health-related topics and earn free continuing education credit at the same time.

This Week:

• Legal and Ethical Implications of AI

Speaker(s):

• Kevin Ryan, JD, MA, BSRT, ASRN
  University of Arkansas for Medical Sciences
• Mark Hagemeier, JD
  University of Arkansas for Medical Sciences
  

Objective(s):

1. Discuss the current state and federal legal restrictions regarding development, deployment and utilization of artificial intelligence generally.
2. Express the potential benefits of adopting artificial intelligence in business applications and social interactions.
3. Identify the potential risks to business operations and current societal expectations that might result from inappropriately regulated implementation of artificial intelligence.

View the calendar event on May 2nd for specific login information.

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The SCTRC partnered with the University of Arkansas for Medical Science (UAMS) Institute for Digital Health & Innovation (IDHI) to provide a comprehensive package of demonstration, presentation, and hands-on learning.

SCTRC Program Manager, Amy Moses, took on most of the facilitating and coordinating of the site visit. “It was an honor to have visitors from across the world come to UAMS to learn more about implementing successful digital health programs,” said Moses.

The first day was loaded with heavy topics like telemedicine business planning, economic development, technology and infrastructure, research, DTC telehealth, and HROB, while also touring the UAMS telenursery and NICU. The second day, the group took a field trip to Batesville, AR, where partners from the UAMS Stroke Program at the White River Medical Center simulated a telestroke event, ending with a tour of the emergency department. The final day of the visit took our guests through the UAMS Simulation Center where many of them were allowed to practice with the learning tools and technology firsthand, then finishing the program with virtual dissection and a presentation from UAMS BioVentures.

The experience was rewarding for all parties involved. Hearing about policies, practices and barriers in foreign countries and sharing our own provided that rare insight that makes the world that much smaller and closer.

“We are honored that USTTI and this diverse group of international visitors chose to travel from so far away to see how UAMS has implemented telemedicine and digital health to help rural communities in Arkansas,” said Wendy Ross, IDHI Director of Programs and Co-Director for the SCTRC. “The learning has gone both ways, of course, and we are inspired by our visitors’ passion to improve health outcomes in their own countries.”

Reference: https://news.uams.edu/2023/03/13/uams-hosts-united-states-telecommunication-training-institute-ustti-for-digital-health-training-program/

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THE ACCIDENT

As the COVID-19 pandemic continues to affect the healthcare system, telemedicine has expanded and evolved to assist patients and families in need including the Tolerson family. On March 21, 2020, Alex Tolerson experienced a seizure while driving, causing him to swerve off the road, hit a tree, spin around, and slam into a brick wall. After paramedics extracted Alex from his car, EMS airlifted Alex to the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Arkansas. There, he was diagnosed with a grade III severe diffusion axonal injury, subarachnoid hemorrhaging, frontal lobe damage, lesions in his brain stem and his corpus callosum, C2 facture, lesion to the left side of his forehead, and broken orbital floor of his left eye. Alex’s accident had left him with a Traumatic Brain Injury (TBI). Surgery was not required, but doctors had to intubate Alex, and place him on a ventilator in a state of unconsciousness. Because this major accident occurred during the beginning months of the pandemic, the Tolerson family experienced even more hurdles for Alex’s care.

COVID-19 IMPACT ON THE TOLERSON FAMILY

Vida Tolerson, Alex’s wife and caregiver, was able to visit with her husband for two hours before he moved to the Intensive Care Unit. After that, she was no longer able to visit him because of restrictions due to the pandemic. Alex’s stay in the hospital lasted until for over a month. All Vida could do during that time was call the hospital to get updates on her husband’s health until he could be moved to a long-term acute care facility (LTAC).  At the LTAC, COVID-19 restrictions again prevented Vida from being at her husband’s bedside. She not only wanted to check on her husband, but also to know how to care for someone with a TBI for when Alex was able to come home. Vida spent time online researching and learning the best ways to care for a TBI patient until she could learn from his healthcare team at the LTAC.

Once Alex was home, Vida dove into caring for him. She quickly learned different therapies, techniques, and massages. It was difficult at first to get into a schedule and to know what he needed. In the beginning, Alex would open his eyes sporadically; he was agitated and storming[i] a lot. After that, the Tolerson family began to find their rhythm. Things got easier. Alex would have his days where he was unresponsive or would become over stimulated, but the family learned to adjust to Alex’s new cues. While the family is making great strides with Alex’s care, the pandemic has created major barriers for him and his family.

TELEMEDICINE INTERVENTION

The Tolerson family lives an hour and a half outside of Little Rock, and away from Alex’s healthcare providers. In order to provide him with appropriate care, limit travel time, and lessen the risk of a COVID-19 pandemic, UAMS worked with the Tolerson family to setup telemedicine video-calls with Alex’s physiatrist.[ii] This alternative method of care saved Alex from the challenges of a trip-by-ambulance to appointments at the Little Rock clinic. The first telemedicine assessment was enough for the physiatrist to take him on as a patient, change medications, change some therapies, and start moving forward with recovery. Since then, the Tolerson family has participated in three telemedicine appointments and Alex has progressed to a state known as minimal consciousness. Through the video capabilities of telemedicine, the healthcare providers were able to see Vida and Alex in their everyday environment.

“I don’t know where we would be without telemedicine–it was great!”
~ Vida Tolerson

One of the most important factors of telemedicine is being able to review Alex’s medications. His healthcare providers reviewed his medications and made a change from one that was keeping him more sedated, to one that was still therapeutic but would allow him to be more alert. Now, after just three telemedicine visits, Alex is moving onto the next stage of his recovery and is starting to emerge a bit more. He can reach for things now, his contractures are good, he opens his hands completely, and Alex’s cervical collar was able to come off. Vida explained that the telemedicine visits helped her better care for her husband. She is able to explain visually any questions or concerns to his healthcare team. “The telemedicine visit allows that one-on-one interaction with the patient that you would never get just picking up the phone and calling,” she explained. Nothing is up for interpretation; the healthcare providers are able to see exactly what Vida is talking to them about. Although communicating through telemedicine is not a physical face-to-face interaction, you are still able to see, hear, and interact with one another.

[1] Storming: Patient’s body’s response to the stress of a severe TBI that can include symptoms such as elevated heart rate, high temperatures, rigid body postures, profuse sweating, hypertension, and fever.

[1] Physiatrist: physical medicine rehabilitation doctor focused on disorders of consciousness. (Some may call this a vegetative state or persistent comatose state.)

Contributors: Eddie Williams, RN, BSN, CBIS, Terri Imus, RN, BSN, Kim Lamb, MS, Kristen Alexander, MPH, MPS

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