Presentation by Joe Tracy, Vice President, Telehealth Services, Lehigh Valley Health Network

1. The LVHN TeleBurnSM Program
Mid-Atlantic Telehealth Resource
Center Summit
March 15-16, 2012
Joe Tracy
VP – Telehealth Services

2. Program Purpose
■
To assess burn patients quickly by both
the local Emergency Room attending
physician and an LVH Burn Surgeon.
– Initiate treatment earlier!
– Triage Enhancement through
Collaboration with a Regional Burn
Center.

3. What is so innovative about
LVHN TeleBurnSM?
■
Outreach strategy involving:
– A service not typically offered by many
small hospitals.
– Visits and presentations to remote sites by:
• Burn Center Medical Director
• VP of Telehealth
• TeleBurn Liaison (on-going sales and service)
– Information Services providing the
technology support.

4. What is so innovative about
LVHN TeleBurnSM?
■
Outreach strategy involving:
– Simple and inexpensive technology for the
remote site.
– Agreements between LVHN and the sites.
– The Guide to Getting Started with LVHN
TeleBurn.
– 24/7/365 response by LVHN Burn Surgeons
– mHealth technologies used at LVHN

5. Back to the Future

6. Emergency Telephone Call – Burn
Remote Physician Description
■
■
■
■
■
■
83 year-old male
Burned his lower leg yesterday while
burning brush with gasoline.
His burn looks to be about 0.5% TBSA.
Wound is pink and moist with blistering.
Patient has a history of diabetes and
heart disease as well as mild dementia.
I would like to treat him here and refer if
there are any complications with healing.

7. Additional Conversation
■
Burn Surgeon: Is his pain controlled and
does there appear to be any signs or
symptoms of cellulitis.
■
Remote Dr.: His pain is controlled and he
does not have any signs of cellulitis. His
wound looks pink.
■
Burn Surgeon: Does the wound blanch?
■
Remote Dr.: It appears to blanch in the
area of blister…..

8. Do you have the image of this burn
in your mind?

10. Case Summary
■
TELEPHONE
– Same verbal
communication
– No Visual
– .5% burn TBSA
– Pt. probably treated
local and sent home.
– Big chance for
infection
– If wound becomes
infected – two
surgeries vs. one
■
TELEHEALTH
– Same verbal
communication
– Couple Digital Pics
– 1.5% burn TBSA
– Pt. transferred to
LVHN Burn Center
– No infection due to
timely treatment
– One surgery – next
day – discharged on
day 5

11. Important Points to Make Based
on the Summary
■
Telehealth provides a better assessment of
the patient, because providers are not
working blindly.
■
Payor implications – two surgeries vs. one
and corresponding LOS differences.
■
Think about the legal issues of
mistreatment.
■
MOST IMPORTANT – think about the
implications for the patient.

12. LVHN TeleBurn by the Numbers
(December 2008 – Current)
■
Hospitals
– 37 installed
– 7 pending installation
– 10 pending agreements
– 4 contacted
– 8 on the radar screen
■
Industry partners
– HealthWorks
– Just Born
– Deka Batteries

13. TeleBurn Encounters To Date
(December 31, 2011)
11%
15%
38%
36%
Admitted to BC
Outpatient BC Only
Remained Local
Other
N = 1132 patients

14. TeleBurn Encounters by Month
70
60
50
40
30
20
10
FY 2011
Fe
b
M
ar
A
pr
M
ay
Ju
n
Ja
n
D
ec
Ju
l
A
ug
Se
p
O
ct
N
ov
0
FY 2012

15. Declining Cost to Implement
TeleBurn
■
2008 TeleBurn – Version 1 - ~$5,000
■
2009 TeleBurn – Version 2 - ~$2,400
■
2009 TeleBurn – Version 3 - ~$400

16. Too Cumbersome!

17. LVHN TeleBurnSM

18. Make Sure You See
The Entire Picture!
Picture – courtesy of Robert Schosser, MD, East Carolina University

19. Accurate Verbal Description, but
the Picture Tells the Story
Picture – courtesy of Robert Schosser, MD, East Carolina University

20. Summary
■
Enhanced communications by adding
a couple pictures to the conversation.
■
Implemented a web-based, mHealth
solution to speed up the emergent
conversation.
■
Built a solid outreach program around
the program.
■
Provide on-going support to the
TeleBurn sites!

21. Questions & Answers
My Contact Information:
Joe Tracy
Vice President – TeleHealth Services
(484) 884-8633
joseph.tracy@lvhn.org