SOURCENov 18, 2013
Dr. Brian Young of Legacy Health believes that in the future doctors in Portland might use telemedicine to help treat patients as far away as Africa.

“Telemedicine really has no limits,” said Young, Legacy’s adult medical director of telemedicine. “I don’t see big obstacles. If you can think of a telemedicine program, you can create it.”

Legacy got into telehealth five years ago with a telestroke program connected to Skyline Hospital in White Salmon, Wash., followed by McKenzie Willamette in Springfield, Legacy Meridian Park and Legacy Mount Hood.

That was just the beginning. Legacy also uses telemedicine technology for intensive care, infectious disease, genetic counseling, pediatric intensive care and pulmonology. It may also add cardiology, maternal-fetal medicine, ophthalmology, pathology and trauma.

In this week’s print edition, we examine the state of telemedicine in Oregon, which has allowed physicians at Legacy, Providence Health & Services and Oregon Health & Science University to connect with hospitals in far-flung locales that don’t have the specialists who practice in a large urban center. The doctors use two-way video conferencing technology, which offers a more immediate interaction than the telephone and can often obviate the need for costly and time-consuming transport to Portland.

One of the areas in which Legacy has distinguished itself in its Legacy Tele-Baby Resusitation. It began at Legacy Good Samaritan Medical Center in May 2012.

Since then, neonatal nurse practitioners have performed 41 tele-baby resuscitations. Legacy has added several locations since June, including Tuality Healthcare in Hillsboro, Legacy Mount Hood and Legacy Meridian Park.

Dr. Lauren Rose, medical director of Newborn Nurseries at Randall Children’s Hospital, said pediatricians in the community and at low-risk birth centers brought the need to light.

“When these resuscitation events happen, staff are prepared but they are infrequent enough, they thought they didn’t have the volume, compared to an ICU, such that staff would benefit from an extra layer of support,” Rose said.

If a newborn at one of the hospitals shows signs of distress, nurses and doctors contact Randall Children’s Hospital within seconds, allowing both sets of caregivers to determine the diagnosis and condition of the baby in real time. The newborn ICU staff is involved much earlier than in the past, at the first sign of distress or complications during delivery.

The Randall’s staff are able to advise based on the newborn’s color, breathing and vital signs and can help determine whether the baby should stay where he or she is or be transported to a Neonatal Intensive Care Unit.

Another area that sets Legacy apart is it burn unit. Located at Legacy Emmanuel, it’s the only burn unit in the state and as such, has been doing low-level consultations by phone. Young said the unit is looking at taking it to the next level with cameras and doing the more comprehensive telemedicine consultations that it does in other areas of medicine.

Eventually, there’s no reason why tele-burn services couldn’t be extended globally.

“We could do wound care management with surgeons in Africa,” he said. “It’s one of those things we have to explore. It’s a matter of logistics.”

Young said he could also see wound care consultations done remotely from people’s homes.

“As a physician, I value touch,” he said. “But the technology is so good, you feel like you’re breaking down the barriers. It gives me the sense I’m in the room with them.”


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