For many people, living in the Midwest means potentially living miles away from the nearest hospital or emergency services. But thanks to technology, doctors in Sioux Falls are able to link to dozens of rural facilities and help treat patients as if they were in the same room.
He thought it was a pinched nerve in his back, but to make sure, Neil Rommereim went to the local hospital to get checked. Turns out it was a good thing he did.
"We realized that he was in fact having a heart attack we did go ahead and initiate eEmergency Room and pulled them up and arranged for a transfer and contacted the cardiologist." Said Jodi Jung, a clinical nurse practitioner at Avera De Smet Memorial Hospital.
Avera De Smet Memorial does not have a cath lab or even a cardiologist on full time staff, but that doesn't mean they don't have access to one. Even though they're 100 miles away, doctors like Dr. Don Kosiak are cyber-linked and can help treat patients like Neil as if they actually were in the room.
"He (Neil) came in with chest pain they activated the system we were able to assist them with interpretation and next steps and talk with the cardiologist and heart doctor we were really able to move your case along probably faster than historically we've done." Said Dr. Kosiak.
Treating heart disease is one of the biggest challenges for rural hospitals. If you live in De Smet like Neil, it can be almost impossible to get a blockage cleared in the optimal 90 minute window.
"If I had to go another 40 or 50 miles, I don't think I would have come out quite as good because the pain was getting more all the time." Said Rommereim.
For Neil the eChest Pain Service was a lifesaver. While Jodi stabilized him, the doctors at the Avera e-Helm bunker rallied the troops down in Sioux Falls.
"While you're doing that Jodi, I'm going to call the Avera Heart Hospital or I'm gonna call for a helicopter and then we will decide based on how long we think it's going to take whether or not he's a candidate for the thrombolytics or are we going to wait until he gets to the heart hospital in Sioux Falls where they will take him into the cath lab." Dr. Kosiak.
Which is where Neil ended up and a stent was placed in his artery. Not all rural emergencies require the full participation of the eHelm staff. Sometimes it just helps having an extra set of eyes.
"It's a second opinion, I don't have to wake up my collaborative physician in the middle the night I can call Dr. Kosiak in the ER and say hey pull up this chest X-Ray give me your opinion on it." Said Jung.
While the added input helps, the system is not designed as a complete cyber takeover, there is still always someone at a patient's bedside.
"I'm not replacing Jodi or her staff and I'm not trying to manage every little detail of the case she's very skilled and has the ability to take care of sick patients my job is to help facilitate those other parts of medicine that are necessary for patient care and then be available if Jodi or someone like Jodi may have a question about next steps." Dr. Kosiak.
It's a common thought that suggests you'll get substandard care if you go to a rural hospital, but through teamwork and technology, the eChest Pain Service does a great job in disproving that claim.
"We being out here in the rural area and running this big telemedicine network we don't really believe that's the case in fact we believe the care is just as good if not better than at our tertiary centers." Dr. Kosiak.
And if you still doubt the system, look no further than Neil.
"It made sense to me and it is a very good program. I'm proof that the results were very good, they did a good job." Said Rommereim.
The eChest Pain Program has been at Avera De Smet Memorial for two years now. With it's success the role of eDoctoring could expand in the future. For more information about Avera eCare and the services they provide just call 877-AT-AVERA.