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Telemedicine in Neurology and Beyond

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telemedicine

Tanya Mack

Emory

Dr. Gregory Esper

Telemedicine in Neurology and Beyond

Womens Telehealth CEO, Tanya Mack sat down with Emory Healthcare’s Dr. Gregory Esper.  Gregory Esper, MD, MBA is currently Associate Professor and Vice Chairman of Clinical Affairs for the Department of Neurology, and he also is Director of General Neurology and Neuromuscular Diseases. He serves Emory Healthcare in the capacity as the Director of New Care Models.

Dr. Esper shared his perspective of the role of telemedicine in neurology, as well as how Emory Healthcare is evaluating other areas of need for access to care where telemedicine can be deployed to simultaneously provide greater efficiency for patient and care provider, as well as improving the health of the population served.

 

We talked about how patient information is protected while using this technology, as well as some of the current limitations that confound expansion of telemedicine to the patient’s home on a larger scale.

Throughout the world and US, there is a shortage of neurologists, which is expected to worse, not improve in the coming years. The access is outstripped by the demand, especially in rural areas, where
geographical disparities exist. Georgia has over 100 counties that have no neurologist.

Telemedicine improvements and patient and provider adoption, especially over recent years, has proven that in many cases, reliable remote diagnosis can be made, patient outcomes are positive and costs can be saved.

Treatment of stroke, multiple sclerosis, Parkinson’s, epilepsy and some urgent neuro problems can be
managed via telestroke medicine. In 2016, Emory University opened a remote telemedicine service.
Listen in as Dr. Greg Esper updates us on new developments in telestroke and Emory’s new program.

Talking Depression With Dr. Mark Rappaport

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depression

Dr. Mark Rappaport

Talking Depression With Dr. Mark Rappaport

Mark Hyman Rapaport, M.D., the chair of the Department of Psychiatry and Behavioral Sciences and the Reunette W. Harris Professor at the Emory University School of Medicine and the chief of Psychiatric Services at Emory Healthcare, will discuss depressive disorder when he appears on the Medical Association of Georgia’s (MAG) ‘Top Docs Radio’ program on the Business Radio-X Network at 12 p.m. today, Tuesday, December 27.

“Major depressive disorder has a lifetime prevalence rate of more than 15 percent,” says Dr. Rapaport. “That means some 900,000 people in the Atlanta region alone will suffer from an episode of major depressive disorder at some point in their lives.”

He explains that, “Major depression is associated with increased overall mortality, increased suicide rates, and marked dysfunction at work and in social settings. In addition to the individual, depression affects the patient’s loved ones and colleagues and friends.”

According to Dr. Rapaport, depression is highly comorbid with other medical conditions such as heart disease or high blood pressure or diabetes, and it adds exponential costs to the treatment of those disorders.

He also points out that a World Health Organization study determined that depression is the second greatest cause of disability in the world – and the first among women who are over the age of 18.

Dr. Rapaport will discuss major depressive disorder care, including evidence-based psychotherapies, pharmacological treatments, and somatic therapies – stressing that, “One in three patients who suffer from depression have a form of depression that tends to be resistant to most typically employed treatment interventions…more than 300,000 people suffer from treatment resistant depression in the Atlanta area.”

MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG’s ‘Top Docs’ show has reached more than 8,300 listeners – which includes people in all 50 states and 84 countries.

MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.

Click to listen to ‘Top Docs Radio’

Click for Emory Department of Psychiatry and Behavioral Sciences web page

Mental Health Resources

Emory Outpatient Clinic: 404.778.5526

Emory Treatment Resistant Depression Clinic: 404.712.8732

National Suicide Prevention Hotline: 800.273.8250

Georgia Crisis and Access Line (for immediate assistance): 800.715.4225

Depression and Bipolar Support Alliance/Atlanta Chapter: www.atlantamoodsupport.com

Mental Health America/Georgia Chapter: www.mhageorgia.org

National Institute of Mental Health: www.nimh.nih.gov

National Alliance on Mental Illness: www.nami.org

Centered Pregnancy

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centered pregnancy

Anna Cherry, CNM

Centering Pregnancy

On this week’s show, Womens Telehealth’s Tanya Mack sat down with Certified Nurse Midwife, Anna Cherry, of Providence Women’s Health Care of Roswell, to learn about how the centering pregnancy prenatal care program their practice has been participating in is improving outcomes for the patients they serve.

Centering Healthcare Institute explains how centering pregnancy works:  Centering group prenatal care follows the recommended schedule of 10 prenatal visits, but each visit is 90 minutes to two hours long – giving women 10x more time with their provider. Moms engage in their care by taking their own weight and blood pressure and recording their own health data with private time with their provider for belly check.

 

Diabetes Telehealth Network

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Telemedicine education

Tanya Mack of Womens Telehealth

Diabetes Telehealth Network

As patients want more control and visibility to their health data and mHealth (mobile health) and
technology are evolving daily, remote patient monitoring has emerged as a viable way to manage chronic diseases, such as diabetes. Remote home monitoring works by collecting health care data at the
patient’s home and then transmitting this data to health care providers in real time to make modifications if needed, avoid unnecessary hospital visits and prevent some serious long term
complications.

The University of MS has been one of the nation’s leading telehealth providers logging over 500K patient encounters, covering 35 medical specialties and serving 218 locations statewide. In 2014, the university developed the Diabetes Telehealth Network.

It has been estimated that the cost of diabetes in the US exceeds $2.7B/ yr. Real time insights and the ability to talk to patients remotely can lead to improved patient outcomes. The results of their pilot program have been astounding and now serve as a model for other states with access and limited provider resources to follow.

Join us today as we listen to Michael Adcock, Director of Network Strategies talk about this innovative and effective RPM solution.

MAG Mutual Patient Safety Institute

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MAG Mutual Patient Safety Institute

The MagMutual Patient Safety Institute is comprised of physician consultants, nurse consultants, loss control consultants, attorneys, and other specialists who are diligently working to identify the risks that today’s physicians and hospitals face,” says Dr. Bohlke, who is a member of MAG Mutual Insurance Company’s Board of Directors. “Their goal is to provide those physicians and hospitals with guidance and advice on how to minimize or eliminate these risks so they can focus on providing quality patient care.”

Dr. Bohlke has a family practice in Brooklet, which is about 50 miles northwest of Savannah, and he served as MAG’s president in 2012-2013.

MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG’s ‘Top Docs’ show has reached more than 8,000 listeners – which includes people in all 50 states and 84 countries.

MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.

MagMutual provides medical professional liability (malpractice) insurance in Georgia and other states in the Southeast U.S. It is one of the largest medical liability insurers in the U.S. The company is rated A (Excellent) by A.M. Best.

 

Click for MagMutual website

 

National Prematurity Awareness Month

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march of dimes

Tanya Mack and Danielle Brown

National Prematurity Awareness Month

The CDC website explains the reason behind National Prematurity Awareness Month this way, “In 2015, about 1 out of 10 babies was born too early in the United States. Learn about the problem, risk factors, and what we can do to reduce premature birth.

About Premature Birth

Important growth and development occur throughout pregnancy—including in the final months and weeks. Premature (also known as preterm) birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. The earlier a baby is born, the higher the risk of death or serious disability. In 2013, about one-third (36%) of infant deaths were due to preterm-related causes. Babies who survive can have breathing issues, intestinal (digestive) problems, and bleeding in their brains. Long-term problems may include developmental delay (not meeting the developmental milestones for his or her age) and lower performance in school.”

Womens Telehealth’s Tanya Mack sat down with March of Dimes’ State Program Manager, Danielle Brown.  Brown explained the extent of occurrence of premature births among Georgia women and how it ranks nationally on the low end of the scale.

We explored some of the reasons behind these troubling numbers, research underway to address it, and strategies being employed around the state to bring needed screening and pre-natal care to expectant mothers.

Danielle talked about why we need to have a National Prematurity Awareness Month and some of the ways it is making a difference.

As Tanya explains, for the first time in eight years, the premature birth rate in the United States increased. Nov. 17 th was World Prematurity Day and this is Prematurity month. Approx. 15 M babies are born annually prematurely and about 1M of these/yr die before their 5 th birthday. Premature birth affects about 1:10  babies in the United States and it remains the leading cause of death in babies in the US.

World wide, it remains the number one reason for infant death as well. Premature birth is defined as a baby born before 37 weeks gestation. Babies born early can not only be at high risk on delivery, but can have health issues such as vision and hearing issues, lung problems and intellectual delays that remain long term problems. Many premature births can be prevented. Join us today as we listen to March of Dimes representatives discuss prematurity and it’s prevention and treatment.

 

 

Infectious Disease

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Infectious Disease Specialists of Atlanta

Infectious Disease

Medicine is becoming increasingly fragmented and complex. The infectious diseases specialty has become especially pivotal in our health care system when it comes to clarifying diagnoses, preserving our antibiotic armamentarium with cautious use of this limited resource, and protecting patients from complications that are associated with these complex treatments.

Unfortunately, the number of young physicians who are going into the infectious diseases specialty is declining. Two years ago, more than 40 percent of infectious diseases training programs (slots?) went
unfilled (i.e., a program seeking three new trainees might only get two and some smaller programs might not get any)  – while last year more than 60 percent of infectious disease training programs were short of fellowship trainees.

It is essential to convince more young physicians to go into the infectious disease specialty if we hope to
ensure that patients have access to the care they need.

After Dr. Dretler graduated from Tufts University Medical School in Boston in 1978, he trained in internal medicine at St. Elizabeth’s Hospital of Tufts University. He completed his infectious disease training at Emory University in Atlanta in 1981. He then started his Infectious Disease Specialists of Atlanta practice at DeKalb Medical where his group is now based.

He has served as president of the Infectious Disease Society of Georgia, as the president of the DeKalb Medical Society, and as both the chief of medicine and the chief of staff at DeKalb Medical. Dr. Dretler also served as the medical chairman of the DeKalb Medical Foundation. He has been heavily involved in medical research and has been a principal investigator for 25 years on more than 100 NIH studies, including clinical research in AIDS, Hepatitis C, Pseudomembranous colitis, and influenza. Dr. Dretler has published more than 25 articles and posters.

Talking Allergies With Dr. David Redding

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Tanya Mack and Dr. David Redding

Talking Allergies with Dr. David Redding

Spring and summer blooms are over so why are you still sneezing? Pollen doesn’t stop at Labor Day! The culprit may be fall and winter allergens such as ragweed, mold and dust. The CDC reports that over 50 million Americans suffer annually from allergies. Almost 75% of people that have reactions to allergens in the spring, also have a reaction in the fall and winter.

There are 17 species of ragweed in the US (and pollen can travel hundreds of miles) and one plant can release 1 billion grains of pollen. Recent studies have shown that increased temperatures have extended the fall allergy season. It may not seem that allergies are not that serious at first blush, but allergy problems can greatly affect the quality of life in terms of sleep, work and school productivity.

Colds are also common during fall and winter months, but many people do not know how to distinguish between a cold and allergies. Dr. David Redding, a board-certified allergist, who has been featured on the Weather Channel and TLC joins us to discuss the triggers and treatments of fall and winter allergies.

Special Guest:

Dr. David Redding, MD, Redding Allergy Center

allergies

Dr. David Redding

Practice Architectural Design

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Medical Association of Georgia

Louise Labus

Practice Architectural Design

Architectural Interiors for medical practice space is ever changing with new technology, medical developments, more complex patient needs, integrated medical professional work patterns, rising cost of construction, new lighting and finish selections based on health and environmental regulations and more.

Balancing the rising cost in construction and the needs within medical spaces can be challenging. It is critical for the design professional to work hand-in- hand the with physician and practice staff and to employ good communication and listening skills. It is the architect/designer’s responsibility to provide the most appropriate options based on the practice’s objectives in creating aesthetically pleasing and optimal spaces for the patients, physicians and staff.

Louise Labus is a senior associate at Collins Cooper Carusi Architects. She is a licensed Interior Designer with the State of Georgia and Professional Member of American Society of Interior Designers (ASID). Louise has been in the interior architecture and design field for more than 30 years. Ms. Labus has an interior design degree from Michigan State University.

She is focused on medical design, but her background also includes corporate offices, retail space, religious facilities, and educational institutions as well. Ms. Labus strives to understand the needs of her clients throughout the design process – going above and beyond due diligence and programming process to provide a truly customized, comfortable space for every client. She takes a “human-centered” design approach to medical practice interior architecture.

End of Life

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End of Life

Dr. Richard W Cohen

End of Life

End-of- life is a significant issue for patients, families and health care teams. The Institute of Medicine and the book ‘Being Mortal’ have increased the awareness of the public and the health care profession. The key to the issue is the ability of a patient to express their wishes for how they chose to live out their life and the ability of the health care team to honor those wishes.

Those wishes are documented in an ‘Advance Directive’ and, when appropriate, in a ‘Physician Orders for Life Sustaining Treatment’ (POLST). The POLST is a medical order that aims to enable seriously
ill patients to designate the treatments they desire and to ensure that those preferences are honored by medical professionals.

The Georgia POLST Collaborative is a part of the National POLST Paradigm. The Georgia POLST
Collaborative aims to educate patients, families and health care professionals throughout the state about end-of- life planning, advance directives, and the Georgia POLST.

Dr. Richard Cohen recently retired as the medical director of the WellStar Health System’s Ethics Department. He founded Wellstar’s Health System Ethics and Advance Care Planning and End-of- Life programs. Dr. Cohen is the chairman of the Board of Georgia Health Decisions, the chairman of the Georgia POLST Collaborative, and a member of the Executive Committee of the National POLST Paradigm Taskforce.

He practiced total joint restoration in Atlanta for 40 years. Dr. Cohen received he medical degree from the Jefferson University Medical School in Pennsylvania.