CASE STUDY

TELEMEDICINE

Telemedicine and videoconferencing

bring specialized healthcare to rural America.
Located in south-central Iowa, Clarke County takes pride in providing a quality standard of living for its residents. Home to more than 9,000 people, Clarke County is committed to growing with the community as it offers a friendly rural environment with excellent schools, local businesses and healthcare.

SITUATION
The Clarke County Hospital in Osceola, Iowa is the hospital of choice for many of Clarke Countys residents due to its nearby quality healthcare coupled with a warm and caring environment. However, doctors at the hospital regularly found themselves sending their patients to seek care from a specialist nearly an hour away in Des Moines. Many times, the care received in Des Moines could have been administered at the Clarke County Hospital under the direction of the specialist. In addition to the travel incurred by patients, specialists would occasionally travel to Clarke County on a weekly or monthly basis to see patients, but these specialists struggled to find time to make the drive to Osceola. Looking for ways to offer specialist care while keeping residents and doctors closer to home, Clarke County officials began researching telemedicine and toured a telemedicine facility in Kansas City. The facility impressed Clarke County officials so much that they called the manufacturer, Cisco, to begin discussions on finding the right solution for their hospital. Cisco recommended the same company that had deployed the Kansas City telemedicine facility, SKC.

Weve challenged SKC in dreaming up a solution and weve changed our minds multiple times, even during installation. I wondered how SKC would respond and theyve been great. Weve worked through our changes and obstacles and theyve provided a great response to meeting our needs.
Vicki Irvin Chief Clinical Officer

SOLUTION
SKC began designing a solution that would enable patients to connect to several specialists throughout Des Moines while still receiving the same quality care as if they had traveled to visit the doctor in person. To accomplish this, each videoconferencing unit is equipped with medical devices, such as stethoscopes, allowing the specialists to perform tests and check-ups through the connection.

SKC began phase one of the installation project in September 2009, finishing two weeks later. The first phase included retrofitting three patient rooms with Cisco TelePresence Edge 95 MXP HD videoconferencing systems, ceiling microphones, conduits and integrating AMD devices. SKC also installed Cisco TelePresence 1700 MXP systems at two doctors locations in Des Moines and set up the project infrastructure for phase two.

SOLUTION (cont.)
The second phase began in December 2009 and included the retrofitting of 12 more patient rooms in addition to installing units for ER and surgery procedures. Hospital IT and conferences rooms were also outfitted with videoconferencing systems. Specialists received Cisco TelePresence Movi systems which allow them to log into the hospitals bridge and administer care from home. Additionally, schools and retirement centers were equipped with video units in order to provide health education and prevention.

RESULTS
The hospital saw immediate results after completion of the first phase, as patients began saving time and money by avoiding the commute to Des Moines. The hospital itself is also saving its resources now that it can take care of more life threatening issues instead of using an ambulance or helicopter to transport patients. The second phase of the project was completed in the summer of 2010, adding 12 units to serve additional patients in Osceola. Ideally, wed like to have telehealth access in every patient room instead of having to drag a telemedicine cart throughout the hospital, said Vicki Irvin, Chief Clinical Officer. We want this to be as simple as possible for both our staff and the specialists in Des Moines. Making the process simple for the specialists has been a key in the success of the program, as Clarke County has had to work with the specialists to ensure scheduling and billing fits smoothly into their daily routine. Input from the specialists, as well as mock runs and community focus groups all went into the planning and execution of this telemedicine program. We have a lot of dreams for our system; were not doing this just to do it, Irvin said. We want to make sure were offering a better service all the way around, down to making sure the video unit is where the doctor wants it placed in the room. We arent ones who just nod our heads and say, Yes. Weve challenged SKC in dreaming up a solution and weve changed our minds multiple times, even during installation. I wondered how SKC would respond and theyve been great. Weve worked through our changes and obstacles and theyve provided a great response to meeting our needs. The completion of the first phase brought Clarke County residents access to cardiology and vascular specialists in Des Moines through their local hospital, and with the addition of new systems, the hospital plans to add psychology, neurology and nephrology in the near future. Eventually, Clarke County officials hope to also offer orthopedics and dermatology through telemedicine, providing their residents with larger city healthcare in the comfort of their hometown.

Cisco TelePresence Edge 95 MXP Cisco TelePresence 1700 MXP Cisco TelePresence Management Suite Cisco TelePresence Video Communication Server Codian MCU AMD Medical devices Global Media Medical devices

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