UMC Health System - Physician Notes

LUBBOCK LUBBOCK GUIDED BY TELEMEDICINE, A RURAL EMERGENCY DEPARTMENT PROVIDES LEVEL 1 TRAUMA CARE TO EMERGENCY PATIENTS. Coached by a physician in Lubbock, a nurse practitioner in Muleshoe sedated the farmer, set his shoulder, X-rayed it and put it in a sling. Two hours after arriving in the ER, the farmer went back to work. KEEPING PATIENTS LOCAL About 100 agricultural laborers a day lose work time due to injury, according to the Centers for Disease Control and Prevention, so it's not surprising that rural hospitals see plenty of injured patients. However, unnecessarily transporting those patients to a Level 1 trauma center burdens everyone involved, from overworked ER doctors to the patients themselves, who suffer longer, lose more work time because of delayed treatment and often receive an expensive ambulance bill, too. Such was the case with MAMC, until the July 2017 partnership, Fleenor said. Now, thanks to remote technology in the form of a handheld camera and a Bluetooth stethoscope and otoscope, an ER physician in Lubbock can virtually observe as emergency staff in Muleshoe provide hands-on treatment. e patient receives access to Level 1 trauma care without leaving town. Preliminary data shows that "inappropriate transfers" from Muleshoe to Lubbock have decreased by half under the new system, Fleenor said. Most of those cases weren't as clear- cut as a separated shoulder, he noted. A farmer who'd been kicked in the head by a horse, for example, would have been sent to Lubbock as a precaution even if a CT scan revealed no bleed. Now, through telemedicine, that farmer could remain at MAMC under observation. Christopher Piel, M.D., medical director of the Emergency Center at UMC, said many non-injury cases that might have been transferred there from Muleshoe — febrile children, pregnant women, patients with abnormal labs — are now being treated just as successfully through telemedicine. Dr. Piel is especially encouraged by how well the system works for minor burn cases. He hopes to replicate that model at other rural hospitals in the region, which still routinely transfer those patients to UMC. "We evaluate them and might do a little burn care, but there's nothing emergent that we do for that. en they go back and we follow up in the clinic," LENDS A (VIRTUAL) HAND IT'S THE SORT of story you tend to hear in the ER at Muleshoe Area Medical Center (MAMC), a critical access hospital in West Texas: A farmer dislocated his shoulder while hooking up his plow. Had the farmer shown up at MAMC two years ago, said the hospital's CEO, Dennis Fleenor, he would have been diagnosed and then sent for treatment to Lubbock, 70 miles away. "It would have taken him an hour and a half to get there, a couple of hours to be seen, a couple of hours to be observed — and he's lost an entire day of work." But this story had a happier ending, thanks to an emergency telemedicine partnership established last year between MAMC and UMC Health System. 4 PHYSICIAN NOTES /// SUMMER 2018

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