Telemedicine benefits patients and staff with remote diagnosis and treatment for rehabilitation

Telemedicine has been growing in use across Mayo Clinic. A recent move by Mayo Clinic Health System's Northwest Wisconsin Region to use telemedicine for patients' rehabilitation appointments is one example of how telemedicine can benefit patients and staff.

Initially, Catherine K. Schmidt, D.O., with Physical Medicine and Rehabilitation at Mayo Clinic Health System in Eau Claire, Wis., wasn't sure if telemedicine appointments would work for her patients. "Physical medicine is very hands-on," she says. "But then I thought about how difficult it is for patients who've had a stroke, for example, to travel to Eau Claire from our more-distant sites."

Dr. Schmidt's team began working with Mayo Clinic Health System sites in Barron and Rice Lake, Wis., to offer telemedicine appointments in July 2013. In addition to making technology preparations, Bethany A. Miller, an athletic trainer with Rehabilitation Services and Physical Therapy at Mayo Clinic Health System — Northland in Rice Lake, spent time in Eau Claire with Dr. Schmidt and Jay Loftsgaarden, M.D., chair of Physical Medicine and Rehabilitation, for training. The team also tested a mock telemedicine appointment successfully.

Telemedicine appointments

When patients arrive in Barron or Rice Lake for physical medicine telemedicine appointments, Miller rooms them, takes their vitals, verifies the information in the electronic medical record and then calls the specialist, who enters the room via telemedicine videoconference. "If Dr. Schmidt requests special tests or assessments, such as range of motion, manual muscle testing, dermatomes and myotomes, ligamentous testing — anything that tests the function of the affected limb or region — I perform them," says Miller. "I act as her hands."

Patient response to the program has been positive. "One of our patients drives to Rice Lake from Ashland, Wis., about two hours away, for his appointments," says Miller. "The drive to Eau Claire would be another hour. The patients appreciate the effort to bring their rehab closer to home."

Dr. Schmidt also is sold on the program. "I actually like the telemedicine visits, because the patients are much more focused in on the appointment," she says. "And the trainer at the site is very much focused on what the patient needs, because she's involved in the visit. Rather than reading my notes, the trainer knows exactly what's going on with the patient."

Best applications

The program is offered as an option, and Dr. Schmidt presents appropriate patients with the opportunity to participate in telemedicine appointments at their home clinics.

In addition to saving patients time, telemedicine saves staff time. Specialists were driving up to 60 miles from Eau Claire to other sites in the Northwest Wisconsin Region. Telemedicine has helped reduce driving time without requiring additional staff.

Kristy A. Hanson, Administration, leads the telemedicine project for the Northwest Wisconsin Region. She says that telemedicine use is growing: Eight clinics in the region offered specialty services via telemedicine by the end of 2013. "There are a few minor processes that need tweaking, but, generally, we've had good feedback from patients and providers," she says.