Mills Memorial Hospital staff are using two-way video conferencing to connect pediatric specialists at BC Children’s Hospital in Vancouver with young patients in Terrace.
The tele-pediatric intensive care unit (tele-PICU) is a mobile cart with a high-definition camera run through two video screens, one facing the operating physician and the other facing the patient. The equipment allows physicians from two separate sites to care for a patient together.
“If we need more specialized advice that’s when the pediatric internists are really helpful,” said Dr. Zaneta Lim, a pediatrician at Mills Memorial. “Seeing the child in real time helps us make better decisions.”
She explained that in severe cases, sick children can actually appear to be relatively healthy until they suddenly crash, which can lead to complex situations when trying to stabilize the patient.
Through tele-PICU, doctors can connect with pediatric intensive care subspecialists in Vancouver, who can then make the call as to whether or not a transfer is needed.
Terrace was the first Northern Health site and one of nine sites provincially to join the initiative. The Mills Memorial team gained the capabilities of using the equipment in November 2017 and used the mobile cart for the first time in mid-March 2018, according to Cara Christopherson, communications officer for BC Children’s Hospital.
Dr. Lim said she has used the tele-PICU cart twice before, the first involving a child in respiratory distress. When she felt she needed a second opinion, she was able to connect with pediatric intensive care subspecialists in Vancouver who then assured the staff at Mills Memorial that the patient as stable enough to remain in Terrace.
“If this camera wasn’t here it would be completely based on my clinical exam and clinical judgment,” Dr. Lim said. “The whole idea is when I’m asking for help I feel like I’m missing something, or I feel like I’m not seeing something that they might see.”
The cart can also come in handy in smaller rural communities where pediatricians may not be readily available or have enough training to treat difficult cases. As a pediatrician in Terrace, Dr. Lim said she takes phone calls from all the surrounding communities like Smithers, Prince Rupert, Hazelton, Houston and health centres in the Nass Valley.
In theory, if these communities also had a tele-PICU cart, Mills Memorial staff “could connect anywhere”, saving not only the patient’s family the cost of a medical evacuation but the healthcare system as a whole, according to Dr. Lim.
“I think it’s the future of medicine in rural communities,” she said.
“We’re always caught thinking, is this patient going to need a transfer? Is this a patient that I’m managing properly? Is there a step that I’m missing? This is what’s going to help us feel more confident when we have those really tough cases.”
The hospital in Terrace is currently working on getting a stethoscope for the mobile cart so the physicians in Vancouver can hear the lungs, heart, and stomach of the patient.