ePoster Presentation

(EP-165) Telemedicine for Concussion Management: A Quality Improvement Pilot in Washington State

Monday, April 24
10:01 AM - 10:15 AM
Location: Experience Zone - ePosters

1. Recognize telemedicine can be utilized to facilitate concussion management in conjunction with athletic trainers and primary care providers.
2. Recognize that telemedicine utilization does not need to involve costly systems and equipment.
3. Recognize health equity is an issue with that goes beyond the rural/urban divide.

Quality Improvement Study
Year(s)/Month(s) Study Conducted: Fall 2016 Sports Season (Football and Girls’ Soccer)
Disease/Condition Studied: Concussion
Subjects Studied: High School Athletes from 27 schools in Western Washington
Setting: Training rooms, primary care offices
Intervention(s): HipaaBridge was utilized for this project as a secure messaging and videoconferencing platform as it is free for both the provider and the user. A SCAT 3 done during the visit by the provider or done immediately before the visit and reviewed during the visit. The trainer assisted with the conduction of any neurologic exam. All visits were conducted via smartphone or tablet.
Outcome Measurement(s): Time to see specialist; travel to specialist, user satisfaction; decreased health care cost
Preliminary Analyses (Analysis of Ongoing Study): Increased access to specialist, within minutes if needed; decreased both travel and time to appointment; satisfaction having specialist available; increased health equity with access to care.

This study is currently ongoing and final results are not yet available.

It is possible to utilize free HipaaBridge software and ordinary smartphones and tablets to conduct telemedicine visits with athletes to provide safe, timely, effective, efficient, equitable and patient-centered care. Further studies to expand this method of care should be encouraged to facilitate safe concussion care including assessment, return to play, return to learn, and a resource for care providers.

Cydne Marckmann

Nurse Practitioner
Frontier Nursing University

Dr. Marckmann is a Nurse Practitioner in Washington State who has practiced in Primary Care, Emergency and Sports Medicine for the past 17 years. She has been on the sidelines for a variety of high school sporting events for the past 9 years where she became interested in concussion management for her athletes. Although Washington was the first state to pass the Lystedt Law mandating the removal of athletes from play, there were no policies to return athletes to play or learn. She developed a return to learn policy for her athletes and authored a Return to Play protocol for Washington’s third largest school district that mirrored the CDC recommendations; this policy has now been adopted by many other districts in Western Washington. Seeing many athletes without access to care and providers without real-time concussion resources, Ms. Marckmann sought to address the health inequity with telemedicine. Dr. Marckmann received her Doctorate of Nursing Practice in 2016 from Frontier Nursing University and her Masters of Nursing as a Nurse Practitioner in 1999 from the University of Washington. She holds an affiliate clinical faculty appointment with the University of Washington School of Nursing. She is a Fellow of the American Academy of Nurse Practitioners since 2013.


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Brian Krabak

Clinical Professor
Rehabilitation, Orthopedics and Sports Medicine University of Washington and Seattle Children’s Sports Medicine

Brian J Krabak, MD MBA FACSM is a Clinical Professor at the University of Washington and Seattle Children’s Sports Medicine. He is an internationally recognized expert in sports medicine, providing sports medicine care and lecturing throughout the world. His sports medicine experiences have included the Olympics (2012 US Olympic Marathon Trials, 2010 Vancouver Games, 2004 Athens Games, 2002 Salt Lake Games), professional baseball (Baltimore Orioles), USA Swimming National Team and collegiate sports (University of Washington, Seattle University, Johns Hopkins). He is currently the Medical Director for the 4 Deserts Series Ultramarathons (held throughout the world) and the Seattle Rock-n-Roll Marathon.

He is a regular speaker at various sports medicine courses/organizations including ACSM, AAPM&R, and AMSSM. His clinical expertise and research relates to injuries and illnesses in endurance athletes, runners, triathletes and swimmers.


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Diane John

Frontier Nursing University

Dr. John obtained her PhD in Nursing from Barry University, Miami Florida, and a Masters in Nursing- Family Nurse Practitioner from Florida Atlantic University in Boca Raton, Florida. Her professional experiences include over 16 years in academia as an Associate Professor, and Nursing Program Director. Dr. John serves as a faculty mentor for advanced practice nursing students and serves as the chair for student’s dissertations and DNP projects. Her service to the University includes the position, Chair of the FNU, and membership on various committees. As an ARNP-Certified Family Nurse Practitioner she provides healthcare to vulnerable populations, which include geriatrics and veterans. Dr. John’s areas of scholarship include, nursing education, technology, and epidemiology.


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(EP-165) Telemedicine for Concussion Management: A Quality Improvement Pilot in Washington State

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