Increasing frequency of doctor visits may help patients heal faster, go home sooner.
Oregon Health & Science University is one of a handful of medical centers nationwide to study whether using a high-tech mobile robot to monitor patients' progress following surgery results in increased patient safety, fewer postoperative complications, shorter lengths of stay and improved outcomes.
The five-foot tall, cordless robot, also known as RP-6, features a digital video camera, flat panel monitor, speakers and a microphone that enable clinicians to interact with patients via the Internet, as if they were physically in the room. Its round wheels allow it to move in any direction, and 24 sensors keep it from running into staff or sensitive equipment. All that's required to operate the unit is a computer and a joystick.
In-person daily visits to the patients' bedsides by attending physicians, also known as rounding, is the traditional postoperative care model for most hospitals. However, recent advances in wireless Internet technology, along with decreasing costs for this service, have prompted many clinicians to consider RP-6, or tele-rounding, as a method to augment communication between physician and patient.
A lot of the problems in medicine today relate to communication and not having the appropriate expertise in the right place at the right time, said John Hunter, M.D., chairman of surgery, OHSU School of Medicine, and co-director, OHSU Digestive Health Center. Part of the answer to those problems may lie in this emerging technology called 'tele-rounding.'
RP-6, a creation of In-Touch Health of Santa Barbara, Calif., was designed to allow physicians with patients in multiple facilities to be in two places at once, a situation that greatly appeals to the OHSU study's principal investigator, Michael Conlin, M.D., an associate professor of surgery (urologic surgery), OHSU School of Medicine.
As a busy surgeon, researcher and educator, Conlin must travel back and forth among multiple locations on campus throughout the day. With RP-6, he and his patients can see and speak to one another no matter where he is physically located. Conlin also has a remote control station in his home, so he can check on patients any time, day or night.
If I'm in clinic or in surgery and can't make it to the floor right away, I can use the robot to do a preliminary exam, make an assessment, speak to residents and staff, and quickly address any problems until I can get there in person. That said, RP-6 is not intended to replace in-person patient visits -- it's meant to enhance them, said Conlin.
Right now I see patients (in the hospital) once a day. With RP-6, I can see them two to three times a day. Ultimately, we hope patients will benefit from the increased interaction with their health care providers.
Patients aged 18 or older who are scheduled for minimally invasive urologic surgery at OHSU and requires a hospital stay of more than 48 hours will be asked to participate in the study. Those who consent will be randomized to one of two groups. One will receive standard rounding postoperatively in which all communication from resident, fellow and attending physicians will be provided in-person at the bedside; and those who receive telerounding postoperatively in which resident and fellow physicians will provide evaluations at the bedside and the attending physician will communicate via RP-6. Residents and fellows are medical doctors undergoing specialty training in urology.
All subjects -- OHSU hopes to enroll 20 -- will be asked to complete a satisfaction survey upon discharge. One week after discharge, the medical records of participating subjects will be reviewed to see whether additional physician contact using tele-rounding benefited patients through decreased hospital length of stay, decreased morbidity and mortality, or directly from closer oversight of postoperative management.
This study was prompted by a pilot study conducted at Johns Hopkins in which patients had higher ratings of satisfaction with aspects of their hospitalization when involved with tele-rounding as compared to standard in-person rounding. That finding prompted researchers to ask if tele-rounding is equal in safety to traditional bedside rounds for the care of postoperative patients.
The study will be conducted on the hospital's multispecialty floor and is funded through a grant from the OHSU Foundation and the Department of Surgery, OHSU School of Medicine.
For more information about the OHSU Department of Surgery, visit www.ohsu.edu/surgery/
For more information about RP-6, visit www.intouchhealth.com