"From a wound care perspective, if somebody can show me a photograph, I can guide care so much easier than if someone tries to describe it" - Dr. Raymond Otto

The Wound Clinic at Elks Wound Center has used Conex since November of 2010. Physicians and staff at the clinic work with nurses at four remote locations, using Conex to review information on new patients and ongoing cases. Telephone communication is insufficient in the wound care process, which requires the visual capacity provided by telemedicine technology, explains Dr. Raymond Otto. “From a wound care perspective, if somebody can show me a photograph, I can guide care so much easier than if someone tries to describe it.” Using Conex, Dr. Otto is able to quickly determine a plan of care based on images, not words. “There’s no simple way to describe what somebody's looking at and get an accurate image in mind.”

Physicians normally see remote patients monthly, during scheduled rounds. But nurses making weekly rounds use Conex to keep physicians updated. Administrative Assistant RaeAnna Carlson explains that in cases where “a patient is declining or a wound is getting worse,” a Conex record is viewed to help determine “if it is necessary to round on the patient at an unscheduled time.” With updated photos of a wound, a physician can better decide when to see a patient next, and how best to be prepared for the visit.

The clinic also works with home health agencies, relying on Conex when conditions make patient visits prohibitive. “During the winter months the patients cannot always get to the clinic and so updates can be made with the Conex system,” Carlson explains. Previously, a patient or home health care worker had only the telephone in lieu of a face-to-face visit with a physician. “It is very difficult to actually get a busy physician on the phone to give an update,” says Carlson, and the asynchronous, multimedia capabilities of the Conex system excel in place of the telephone.

Collaboration at the clinic also benefits from Conex. Physicians with changing schedules rely on Conex to share information about a patient who may temporarily be in the care of a colleague. “The physicians all round at the different facilities. So if one physician is filling in for the other they can look up the outside patients on the Conex system and know what has and has not been done or what needs to be completed,” Carlson explains.

“The whole advantage is that it allows me to have a virtual presence” “It makes all the difference in the world” - Dr. Steven Fuller Ph.D., D.O

  

Dr. Steven Fuller is the only pulmonary specialist at West Valley Medical Center, and he relies on Conex to keep him connected when he can’t be present in the intensive care unit. “The whole advantage is that it allows me to have a virtual presence,” Fuller says. Since June of 2010, Conex has helped to extend Fuller’s availability to evaluate patients.

Using Conex to view images, Fuller can more efficiently and effectively care for ICU patients. After he first sees a patient and creates a Conex record, Fuller receives images and video updates from ICU nurses as the patient’s condition evolves. Before using Conex, Fuller often had to rely on phone calls from ICU nurses, verbal descriptions of a change in a patient’s condition. But relying on ICU staff’s description—non-standardized, subjective—was often a problem. The main Conex advantage, according to Fuller, is that it provides images on which to base his decisions. “It makes all the difference in the world,” according to Fuller.

By expanding Fuller’s ability to evaluate a patient accurately, Conex has improved patient care and lowered costs. He recounts an instance of a patient with an apparently infected IV site. A nurse posted a photo to Conex and asked to remove the IV. The patient was attached to a respirator and would have required ambulance transport to and from a radiologist for a special IV treatment. But on seeing the photo, Fuller determined it was a skin irritation, not an infection, and that there was no need to remove the IV. By examining a picture in Conex, Fuller spared the patient a risky—and expensive—transport to another facility.

In the future, Fuller imagines West Valley expanding their use of Conex to allow him to quickly, remotely make an initial evaluation of a new patient. Upon seeing a new patient, a nurse will send a video—including the patient, monitors, and respirators—via Conex so Fuller can make an evaluation from wherever he may be.

 

Conex helps the patient have “meaningful communication to a family member” during a difficult time - Mike Fenello CEO of Complex Care of Idaho

At Complex Care Hospital of Idaho, part of Lifecare Hospitals, an update to a patient’s Conex record provides value to the medical team, but also to the patient’s family. Here, Conex helps the hospital communicate with the loved ones of a patient. CEO Michael Fenello describes the process as Conex helping a concerned family member to keep other loved ones up to date.

Updates are entered into Conex by the physicians and nurses caring for a patient. With the patient's permission, a password to view those updates is given to a designated family member, who may share the password with any other loved ones. This way, Fenello says, Conex helps the hospital provide “meaningful communication to a family member.” He explains that this is a valuable addition to the hospital's communication, not a replacement for phone calls or meetings. Conex helps the hospital help the patient “to be able to facilitate communication within your family” during a difficult time.