By Amy Yurkanin
al.com
DEMOPOLIS, Ala. — Charles Webb survived three strokes two years earlier and began struggling to breathe on June 14. His wife, Mary Webb, called the ambulance to their home in rural west Alabama.
But the closest hospital with critical care pulmonologists was more than one hour away.
Instead of making the long drive to Birmingham or Tuscaloosa, the ambulance quickly arrived at Whitfield Regional Hospital in Demopolis. At the hospital, a team of doctors and nurses placed Charles Webb on the ventilator and monitors and sent all his physical information to critical care nurses at the University of Alabama at Birmingham.
Whitfield Regional has a new partnership with UAB to care for critically ill patients, said Whitfield CEO Doug Brewer. And that means teaming up with ICU doctors in Birmingham to increase options in west Alabama. It’s UAB’s first tele-ICU program.
“It helps us raise our game arguably,” he said, “to the same exact level of care that patients in downtown Birmingham in a high level of acute care at UAB are receiving.”
A hybrid team of on-site doctors and remote specialists have been handling Webb’s care ever since. They removed the ventilator on Monday. His condition has improved, Mary Webb said.
“He’s still got a ways to go, but every day seems to be gradually getting better,” Mary Webb said. “He’s off the vent and today is the day that he’s been sleeping all day.”
Whitfield’s telehealth program started when doctors began using video carts to conference with specialists from UAB. Now patients admitted to the ICU have their physical information automatically transmitted to Birmingham, where nurses watch for changes in their condition. Specialists in kidney care, neurology and pulmonology can also review the data and offer treatment recommendations to the team in Demopolis.
“Critical care pulmonologist and the nephrologist can look at these ICU patients literally around the clock,” Brewer said.
Similar programs exist to help fill needs in rural parts of North Carolina, Massachusetts and Alaska.
“The program requires collaboration between doctors and nurses on site and those working remotely from Birmingham,” said Dr. William Stigler, director of UAB E-Medicine Critical Care.
“When oxygen levels are dropping, when blood pressure levels are dropping, we can jump in the room on a camera and access their chart and help the nurses manage that patient and communicate what we are doing to the physicians on site,” Stigler said.
At Whitfield Regional, it began to take shape during the COVID pandemic, when large hospitals filled with critically ill patients. The smaller, rural hospital stepped up and cared for more than 1,500 patients with COVID, including 500 who needed ventilators, Brewer said.
Now that the pandemic has ebbed, the advances in telehealth at the hospital have been benefiting patients with other serious conditions. Brewer said all suspected stroke patients would have had to seek care elsewhere prior to the partnership with UAB. Now the hospital can keep most of them in town for diagnosis and treatment.
It’s beneficial to patients and their families.
“One of the biggest benefits is that patients can get care close to home,” Stigler said. “It’s not one of those things that you always see reported in the medical literature, but that’s really important for family to be able to visit.”
Dereck Morrison, chief operating officer for Whitfield Regional Hospital, cited the case of a patient with a suspected stroke. Doctors in Demopolis and Birmingham worked together to diagnose dementia and a urinary tract infection that could be treated at Whitfield Regional Hospital.
Before the telehealth program, that patient would have been sent to a larger city. And her daughter, a local teacher, would have had to take her, Morrison said.
“She would have had to find someone to work for her the next day,” Morrison said. “She would have to make arrangements for the childcare for her kids. She would have had to travel to Birmingham and find a place to stay. So, the economic impact not only affects that patient, it affects the family as a whole.”
Demopolis and Alabama have high rates of very sick patients who often need special care for kidney or health failure during medical emergencies. Brewer said rural hospitals must increase their capacity to care for people with diabetes, chronic obstructive pulmonary disease and other conditions that are common in the South.
By keeping those patients in the community, they can help connect them with education programs and local doctors to keep them healthy.
Charles Webb has been able to heal with family nearby. Mary Webb lost some of her vision and can not drive. Since he is being treated locally, she has been able to visit, along with his sons and even his 94-year-old mother.
She has been at his bedside when doctors from UAB have been on video. She has been able to ask questions and talk to his treatment team.
“It’s working great, I think,” Mary Webb said. “I like having two opinions.”
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