St. Luke's Health System in Boise, Idaho, is using Microsoft Lync to power a telehealth cart that allows cancer patients to connect with genetic and nutrition counselors 30 to 40 miles away in rural areas.
St. Luke's Health
System, a nonprofit network of seven hospitals and five
cancer-specialty clinics around Idaho, has implemented a telehealth project
using Microsoft Lync 2010, a unified communications platform that allows users
to participate in video conferences, instant messaging and Web conferencing.
Microsoft offers
Lync as a stand-alone platform, as part of Office
365 and as an app for Android, Apple iOS and Windows Phone.
St. Luke's nutritionists and
geneticists are using Lync to save patients an hour's trip driving to remote
facilities, said Dennis Schmuland, chief health strategy officer for U.S.
Health and Life Sciences at Microsoft.
The implementation by St. Luke's is
part of a shift in telehealth, and health care as a whole, from solo providers
and a fee-for-service model toward shared accountability for the cost and
outcomes, as outlined in the Patient Protection and Affordable Care Act (ACA),
Schmuland told
eWEEK. The Supreme Court upheld the constitutionality of
the
ACA June 28.
"Now it's seen as a
more-efficient vehicle to connect patients with the resources and
multidisciplinary teams they need to improve their health and improve their
outcomes," said Schmuland.
In addition to Lync, the telehealth
setup consists of a battery-powered mobile cart, a Windows 7 desktop configured
as a kiosk and an off-the-shelf high-definition Microsoft LifeCam Cinema
Webcam, all for less than $4,500, according to Schmuland. Most entry-level
telehealth platforms cost above $10,000, he noted.
Because cancer patients suffering
from symptoms such as nausea need to be seen right away, affordable cost and
allowing patients to consult with counselors sooner were key considerations in
implementing the Tele-Cart, according to Kevin Mark, a member of the
infrastructure and operations team at St. Luke's overseeing the project.
"That was actually a big driver
for why we needed to get something out to these clinics at an affordable
cost," said Mark. "It just seemed like the higher-end video
conferencing systems were too cost-prohibitive for what we had available to us.
We already had the Lync system in place."
Even as the telehealth platform
reduced travel by at least an hour in Idaho's rural areas, patients still had
to travel 30 to 40 miles on average for a genetic or nutrition consultation at
St. Luke's cancer facility in Fruitland, Idaho, Schmuland noted in a
blog post.
Some patients travel only a few
minutes to get to a telehealth session at a clinic, and others drive about
three hours instead of four hours, said Mark.
"We're not doing home health
yet, but that's on the road map," Mark added.
By establishing its telehealth
program, St. Luke's wanted the configuration to be "low-touch" so
that clinicians could operate it easily without help from IT, said Schmuland.
"We've been able to create a
controlled environment where nursing staff can literally roll in the mobile
battery-powered cart; they power it on, and it will automatically log in to the
system," said Mark.
With Lync, St. Luke's was looking
for a Web conferencing platform without the audio choppiness of other products,
said Mark. Lync also provides a more "resilient" Web connection than
Skype for St. Luke's genetic-counseling sessions that can run for an hour, he
said.
"That's not to say that [Skype]
isn't a valid platform; it's just that we haven't been able to maintain a
connection," said Mark.
In an early survey, 94 percent of
participating patients have reported overall satisfaction with the
program, according to Schmuland.
At St. Luke's Fruitland facility,
about 42 patients participated. The telehealth program has reduced waiting
times by about seven days, said Schmuland.
One challenge for the project was
getting the power controls on one of the Ergotron cart's computers to work,
according to Mark. "You're supposed to put the computer inside the cart
and there are power controls on top of the tray to wake the computer up,"
said Mark. "We weren't able to connect it that way." The cart's troublesome
design has since been discontinued, he said.
Instead, St. Luke's used a separate
push button through a hole in the front of the tray, said Mark.
Overall, deployment of the Tele-Cart
was simple, said Mark. "In terms of the IT perspective, we were able to
deploy both the cart and the computer setup within a matter of hours," he
said. "It's a repeatable model that was quick to deploy and doesn't
require a lot of training and that seems to have worked pretty well."
Before a telehealth session, a nurse
plugs the cart into a network port in an exam room; it connects to the network
and allows patients to join a virtual meeting with a desktop shortcut.
St. Luke's plans to expand its
telehealth project by implementing the platform at clinics in eastern Oregon. In
addition, USB- and wireless-enabled medical devices such as digital
stethoscopes and video otoscopes on the Lync platform will allow physicians to
monitor patients remotely.
"We're testing a digital
stethoscope that we hope will be able to send heartbeat signals over
Lync," said Mark.
In addition to using Lync, St.
Luke's would like to expand the Tele-Cart to work with Microsoft's
SharePoint Web-collaboration software, said Mark.
"We definitely are looking at
ways to leverage Lync beyond just the traditional video-based collaboration
where we can enhance the patient portal experience and the community portal
from a Web presence standpoint," he said.
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