Dr. Scott Knutson, holding an iPad that connects him with specialists at Regions Hospital in St. Paul, checks a patient’s burn at Trinity Hospital. Submitted photo

Telemedicine is helping to ensure the best care for burn patients at Trinity Health, and it’s being delivered via a common tablet device.

The Teleburn iPad is giving Trinity medical providers and patients access to the expertise of specialists at Regions Hospital in St. Paul, a nationally recognized burn center. Installed on a traditional iPad, the software allows virtual face-to-face discussions between providers at Trinity and Regions and close-up views of burns by the specialists. Encryption safeguards patient privacy in transferring information.

“It really is all about facilitating the decision making for transfers to a burn center,” said Dr. Scott Knutson, Trinity emergency medicine physician. “There’s a lot of low complexity burns that are just routinely managed locally and that’s not really a consideration to go to a burn center, but there’s a lot of in-between areas where either the size or the location or something about it creates concern that they may benefit from a more collaborated, involved approach.”

Burns over large areas or critical areas of the body are straightforward, and these patients tend to get flown to Regions fairly quickly. However, there are many nuances to burn management, and the initial care prior to transport is important. Consequently, there may be a conversation with the burn center even prior to an obvious transport, Knutson said.

A transfer is a logistically involved process. Knutson said decisions to transfer patients aren’t made lightly.

“It’s a big expense to the patient families and companies involved and it is a large step in care. So we also make sure that we’re doing it for the right reasons, that there are indications that patients are going to benefit from that transfer. We make sure that we’ve done our due diligence in maximizing our care locally as well,” Knutson said.

When patients are transferred, Trinity can continue to track their care at Regions and can consult with Regions specialists on follow-up care once patients return home.

Rhonda Gunderson, Trinity trauma program manager, said Trinity and Regions can work together to develop a plan of care that doesn’t require the recovering patient travel back and forth to St. Paul.

The iPad also is used in Trinity’s intensive care unit to assist in caring for burn patients who aren’t stable enough to transport straight from the emergency room.

“That consult with that burn surgeon at the bedside is great,” Gunderson said.

Response is rapid when there’s a need for a consult. Regions has physicians always ready to take a call from any of the referral facilities in its consultation program.

“It is sort of adding another specialist to our coverage care,” Knutson said. “Having that availability of the quick consult, it’s really in many ways not very different than if I call one of our specialists about a patient and they come down and put eyes on the patient in the ER and help coordinate the next plan of care. It’s really allowing us specialty coverage even though it’s 500 miles away.”

The Teleburn iPad doesn’t necessarily change the care being provided locally, but it does add a layer of confidence in the care, Knutson said.

“It adds a component to assuring us that we’re doing the right thing and managing our patients well, and when they need additional services that they’re getting them,” he said. “It’s been helpful in giving us assurance that we are moving care in the right direction.”

There’s also peace of mind in transferring patients because of the familiarity with the people and services at Regions, he said.

In addition to the consultations, Regions sends representatives to Minot twice a year to conduct trauma continuing education and meet with local staff.

“They do give us feedback as far as if there is anything in our process that we could improve on,” Gunderson said.

Trinity staff began using the Teleburn iPads last July. The telemedicine has been used with a couple of cases every month or two. Knutson expects use to increase as staff find benefit and utility from it.

Gunderson said families of burn patients appreciate the consultations because they want to know their loved one is receiving that specialty care. Family members can be present for a consult or otherwise be kept informed of those discussions.

“But it gives a little peace of mind to the family that what’s being done would be done the same in St. Paul, Minnesota, as it is here in Minot, North Dakota,” Gunderson said.