Clinical Services

ePoster Presentation

(EP-103) Beyond Tele-Neurology: Access to Emergent Neurological and Neurosurgical Telemedicine in Rural New Mexico

Sunday, April 23
5:15 PM - 5:30 PM
Location: Experience Zone - ePosters

Objectives
1. Provide better healthcare by overcoming disparities in access to care
2. Achieve better health for patients by providing timely access to neuro-emergent specialty care
3. Reduce patient and family impact of unnecessary transfer from rural to tertiary settings
4. Increase staff comfort with specialty care management through emergent neurological and neurosurgical telemedicine consultation, education and process support


Methods
New Mexico is a rural, multicultural state spanning 122,000 square miles, averaging 17 residents per square mile. Of 2,085,538 residents, 33% live in rural areas. There is a serious disparity in access to specialty care for the economically and geographically marginalized populations including 10.2% Native Americans and 47% Hispanics. August 2014, Department of Neurosurgery, University of New Mexico awarded a 3 year grant for a statewide system providing rural emergency neurological and neurosurgical telemedicine consultation. Methods: clinical treatment and satisfaction data: diagnosis, Glasgow Coma, Hunt and Hess, and Marshall Scores, imaging, Rivermead Questionnaire, treatment and follow-up. Measures selected for enrolled patients: Patient Experience Questionnaire (PEQ) and Telemedicine Satisfaction Questionnaire (TSQ). Follow-up at 30 days after discharge, by telephone. Control data collected up to one year prior to and monthly with implementation. A second control group provided by monitoring the behavior of emergency physicians including those electing not to use telemedicine.

Results
Early results demonstrate overall positive patient and provider satisfaction with the neuro-emergent telemedicine consultation program, decreased percentage of inappropriate transfers, and increased administration of tissue plasminogen activator

Conclusion
Improved patient outcomes, reduction in cost, and provider engagement is critical to successful adoption and sustainability. The complete package of both tele-neurosurgery and tele-neurology access can only add to the individual and community health and cost benefit.

Deirdre Kearney

Clinical Nurse Director
ACCESS & Telemedicine, Department of Neurosurgery, University of New Mexico, School of Medicine

Deirdre Kearney joined the Access to Critical Cerebral Emergency Support Sevices (ACCESS) & Telemedicine Program at the University of New Mexico in November 2014 as a Clinical Nurse Director. Ms. Kearney received her BSN at Texas Christian University (1975) and her MSN at Simmons College, Boston (1998). She is an experienced critical care nurse with extensive clinical, educational, and managerial nursing experience. Ms. Kearney has managed neurosurgical intensive and medical/surgical intensive care units and served as staff educator of Neurosurgical Intensive Care Unit as well as education consultant in clinical education. She is the former Neuroscience Program Director and Unit Director, Neuroscience Intensive Care Unit at University of New Mexico Hospitals.

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Debra A. Banks

Clinical Nurse Director
ACCESS & Telemedicine, Department of Neurosurgery, University of New Mexico, School of Medicine

Debra Banks attended Louisiana State University of Alexandria in Alexandria LA where she completed her RN Associate Degree in Nursing in 1994. In 2002, she completed her Bachelor of Science in Nursing at Northwestern State University in Natchitoches LA. She received her Masters in Nursing Administration in 2012 from University of Phoenix. Debra has worked as a staff nurse on a medical surgery unit, home health nursing as staff nurse and Supervisor of Case Management, rehab staff and charge nurse, Community College Nurse Educator, education coordinator, neuroscience clinic charge nurse, neurosurgery coordinator and Director of Family Medicine Clinic. She is currently working as Clinical Nurse Director of the ACCESS/Telemedicine Program developing educational materials for neuro-emergent patient care for rural area hospital physicians, nurses, and allied staff in different modualities such as on-line learning, classroom presentation, live-streaming and confernce.

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Assets

(EP-103) Beyond Tele-Neurology: Access to Emergent Neurological and Neurosurgical Telemedicine in Rural New Mexico



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