Taking her 3 autistic children on a 6-hour round-trip journey to see their psychiatrist was an ordeal for Mandi Larkin. But with technology provided by Cisco through the Connected Healthy Children program, the family can now see medical experts without leaving their community.
To get the best care for her 3 autistic children, Mandi Larkin would drive 3 hours from her family’s home in Tifton, Georgia, to Marcus Autism Center in Atlanta. The drive to and from Atlanta was exhausting. Missed work, missed school, and the long drive were constant sources of stress.
Today, Larkin’s children receive world-class medical care at her local hospital via a state-of-the-art telemedicine link to Marcus Autism Center. The recently improved telemedicine system was optimized by scientists at the Georgia Tech Research Institute (GTRI) and Cisco. Marcus Autism Center’s telemedicine room is now a showcase for providers of telemedicine, where improved video capabilities and an ergonomic suite allow patients in rural Georgia to meet face-to-face with medical specialists in Atlanta.
“The accessibility to the doctors in Atlanta is the big thing,” Larkin said. “Not everyone has the means to make that kind of a drive. Telemedicine gives us access to the doctors that we normally wouldn’t have access to.”
A major goal of the telemedicine redesign is to create telepresence, clinical workflow, and diagnostic processes that can enable clinicians to identify rural children with autism spectrum disorders as early as 18 months. Today, these children are often diagnosed as late as 7 years old.
Cisco, as a provider of telemedicine equipment at Children’s Healthcare of Atlanta, also donated approximately half-a-million dollars’ worth of equipment and software toward telemedicine enhancements at both Marcus Autism Center and Children’s.
“Cisco worked hand-in-hand with us from the beginning,” said Courtney Crooks, a senior research scientist at GTRI, who is leading the project. “In a patient-provider relationship, the experience is really important. We wanted to ensure that the telepresence is at least as good as when you’re sitting in the office with a provider. Plus, we wanted to use technology to enhance the clinical workflow and capabilities of the provider, beyond what they may be able to accomplish through manual means.”
Felissa Goldstein, M.D., is the primary doctor using the improved telemedicine system at the Marcus Autism Center. Goldstein, a child and adolescent psychiatrist, is one of the most active providers of telemedicine in the state of Georgia. She uses the system for providing early screening and continuing care for children with autism spectrum disorders.
Until this past summer, Goldstein had been using a telemedicine system in her office that, among other human factors problems, had poor lighting, muffled sound, and displaced monitors which created heavily reduced eye contact.
The GTRI systems engineers applied their expertise to Goldstein’s clinical setting. They studied the best way to orient the telemedicine monitors so that the eye contact and visual connection between doctor and patient was optimized without either person having to crane their neck.
Crooks’ team shadowed Dr. Goldstein during her appointments and developed a streamlined, ergonomic telemedicine system.
“GTRI worked with us really carefully to maximize eye contact, and I feel like it’s really adding to my ability to provide good patient care by telemedicine,” Goldstein said.
The new telemedicine system is now in a room of its own. The lighting in the larger space was designed to make Goldstein appear natural, and not dark and shadowy like in the old system. The desk and monitors are now ergonomic, and the room is soundproof.
When Mandi Larkin arrives to her appointment at Tift Regional Medical Center with her children -- ages 3, 4 and 6 -- a nurse guides them through registration and paperwork, then takes the kids’ vital signs and leads the family to the telemedicine room. When they arrive, Goldstein is already on the telemedicine video screen.
“It’s usually very prompt, and that’s something I really like,” Larkin said. “Once you get there you have your appointment time and there’s never more than a 5-minute wait.”
After her telemedicine session, Larkin is faxed a report detailing the visit. Before, she had to bring a pen and notepad to every appointment to have a record of what transpired.
Larkin said she would prefer to be with the doctor in person, but that isn’t realistic, so telemedicine is the next best thing. In some cases, telemedicine is even better than being with the doctor in person, Larkin said.
“I think the doctor gets a little bit more interaction from the kids through the screen because they more or less shut down around new people,” Larkin said. “With telemedicine, to the kids it’s just somebody on a TV screen talking to them. The doctor can see a little bit more and get a little bit more from them than if she was in the room in front of them.”
“We’re helping to screen a lot of children with developmental disabilities so that it’s no longer seven years until they are diagnosed,” Goldstein said. “The younger you can diagnose, the better off you are.”
This Impact Story was excerpted from a Georgia Tech Research Institute case study.