Saturday, January 20, 2018

Stillwater Billings Clinic Director of Nursing Jackie Mohr points to the red eEmergency button.

SBC implements new technology

Columbus resident Steve Sweten recently died. Twice.
But he lived to talk about it.
On June 16, Sweten went to the Stillwater Billings Clinic with chest pains and not feeling well. In short order, his heart stopped beating and CPR brought him back to life.
He was HelpFlighted to St. Vincents in Billings where for the second time, his heart stopped - or as he puts it, “I died again.”
Three stents and a couple weeks later, Sweten is back at his Columbus home recovering.
Playing roles in his survival were good emergency medical care locally and in Billings, as well as a brand new program at Stillwater Billings Clinic called eEmergency.
Based out of the Avera McKennan facility in Sioux Falls, S. D., eEmergency allows local nurses and doctors immediate access to more manpower by simply hitting a big red button on the wall in both trauma rooms at the ER and being immediately connected to a group of 12 emergency room certified doctors and nurses at Sioux Falls.
It is designed for smaller facilities and aimed at providing a wide gamut of help -- from team-leading to making calls to arrange for transfers and nurse documentation. The program went live June 16, following training sessions with nurses and Drs. David Kane and Richard Klee.
Sweten came into the ER just hours after the first training session.

How It Works
Both trauma rooms in the Stillwater Billings Clinic ER are equipped with a large video screen and microphone that allows the Sioux City staff to both see and hear the patient and medical staff.
Once the big red button is pushed, local staff is immediately connected with a nurse and/or doctor. In rural areas, such as Stillwater County, a doctor usually responds from home during the evenings. Although that wait time is not long, having a doctor on the monitor almost immediately is welcomed.
In Sweten’s case, he said he arrived at the ER and the program was explained to him before a doctor appeared on a large screen.
“I could see him and hear him and he could see me and hear me,” said Sweten. “He could ask me questions.”
Dr. Klee arrived at the ER approximately 12 minutes after being summoned to find the normal protocols being followed by the nurses, such as an EKG going, IVs started and an aspirin administered.
When Klee was contacted at home about Sweten, he knew a helicopter would be needed because there was not a paramedic available in Columbus to provide an ambulance transport. Klee asked the nurse to get that started.

Summoning the HelpFlight helicopter, as well as a conversation with the Billings cardiologist who would be treating Sweten, were two elements handled by the eEmergency doctor.
“That was a huge help,” said Klee, explaining that with those two elements being taken care of by someone else, he was free to spend all his time and attention on Sweten. “It worked very well.”
Sweten’s memory is fuzzy about much more, but he said he was impressed with the system.
“Everybody was really professional. I was impressed, with what I remember.”
Sweeten has managed to find humor, saying he now gets to pay for all that professionalism, but it’s better than the alternative.
“It’s better to be here and pay for it,” he said.

What You Need To Know
Calls can last from a couple minutes to a couple hours and are controlled by the local provider. The monitor and camera used are able to zoom in on wounds or other body parts to give an eEmergency nurse of doctor an actual look at what is being treated. Tests, such as EKGs, can also be read through the cameras.
All 12 eEmergency doctors and nurses are certified staff members of Stillwater Billings Clinic, which means they can give orders and order tests. They also have what is called a “bible” on SBC that lists all care providers, their photos, which transport services they use, the names and numbers of other emergency service providers in the county. As explained by eEmergency nurse Rebecca Vande Kieft in the first training class held June 16, this is all done to make operations flow as smoothly as possible.
Nothing is recorded and the cameras go black when an eEmergency provider is not being used.
There is no additional charge to the patient for eEmergency, said Stillwater Billings Clinic Quality Manager Bev Kovanda.

The money it took Stillwater Billings Clinic to become one of 102 rural facilities in eight states using the eEmergency program came from the Helmsley Foundation. That foundation helps support the Sioux Falls-based Avera eCare system expand its service into seven states for rural and under-served areas.
Last week, members of NATO visited the telemedicine-hub in South Dakota looking at ways to employ a similar model to be used to deliver medical services during disasters, according to a June 22 New York Times article.
Stillwater Billings Clinic’s Quality Manager Bev Kovanda said the Hemsley Foundation approached SBC about a grant for the program.