How Cleveland Clinic applies telemedicine for patient, clinician communication

Muhammad Shazam Hussain, MD, heads up Cleveland Clinic's stroke program as director of the health system's cerebrovascular center.

In July, Cleveland Clinic opened its first telemedicine-equipped neurology step-down unit, which uses telemedicine technology to virtually connect stroke and epilepsy patients with their care team members.

The unit features TVs in every patient room in addition to a high-definition web camera built with a microphone and speaker. Providers can video conference with their patients in the unit using the same TV meant to watch movies or shows on.

Dr. Hussain's research and clinical interests include endovascular therapy for cerebrovascular disease and acute ischemic stroke. Prior to the launch of the telemedicine-equipped step-down unit, Dr. Hussain completed clinical work on topics such as mobile stroke treatment units

Here, Dr. Hussain discusses how the telemedicine technology has transformed patient and clinician experiences.

Editor's Note: Responses have been lightly edited for clarity and length.

Question: How will the telestroke technology help improve patient experiences?

Dr. Muhammad Shazam Hussain: From a patient experience point of view, the patient can receive information from the clinical team without having to wait for someone to physically come to that location. As providers, we now can just beam in and go over things with the patient from wherever we're at. For example, when treating an aneurysm, we must follow up the next day and see the patient in person before he or she can be discharged. I'm sometimes working at a different location, so with the telestroke technology I'm able to beam in and talk things over with the patient and get them discharged hours quicker than normal circumstances.

Q: How will the technology affect patient care?

MSH: Stroke is a condition that unfortunately can be quite severe, and it also comes on very suddenly when there are changes. This technology allows providers to immediately beam in and see what's going on with the patient, talk to the nurse, make an assessment over a video link and treat patients much more rapidly than the usual traditional care.

I think patients really like the technology. If they have questions or concerns at different hours, a member from their care team can beam in at that time when they're having that question instead of them having to wait for the next clinician making rounds.

Q: How will provider and care team workflows be impacted?

MSH: As healthcare gets busier and busier, we're seeing more patients than we ever have before, so this technology allows us to see patients in different locations without having to physically be there. 

We've also employed a lot of telemedicine across different hospitals. An example of the use of telemedicine that has been around for some time is the use of telestroke in emergency rooms. If someone comes to the hospital and they are just starting to experience a stroke, we can take our best stroke experts who are at our main campus and we can beam into any hospital across our system. This allows us to make our highest level of expertise available to that patient immediately, whereas with traditional systems we have to call in clinicians.

Q: When did you get idea that adding the telemedicine technology would be beneficial for patients?

MSH: Telemedicine traditionally mostly lives in ERs. The ability to begin cultivating it into the more proper hospital ward has allowed us to now see a real opportunity to expand the use of it into other areas of what we do.

This unit was conceived about two years ago. At that time, it became an important part of our discussions of how we can cultivate telemedicine to help enhance patient care and experience.

Q: Does Cleveland Clinic have any plans to use this type of technology in other step-down units?

MSH: We are evaluating how we can expand it into other step-down units. The intensive care unit is another potential place to add these telemedicine robots that allow providers to beam in and assess the situation. We also just put a robot in our neurology ICU as well.

The technology is becoming very affordable and easier to implement now even as opposed to having specific robot units that require building. Any TV now can essentially be turned into these kind of telemedicine units, with their USB stick or by implementing some type of software. The technology has really come a long way, and hopefully more people keep adopting it into their practice.

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