When oil rig workers in the middle of the Gulf of Mexico need to see a doctor, they turn to a unique telehealth solution designed by XstremeMD and ISI.
XstremeMD connects patients who work offshore on oil rigs and in other remote
environments primarily in the oil and gas industry with physicians who are
trained to handle health issues common with labor intensive workers. According
to their website, “XstremeMD is the only
telemedicine provider with a staff composed of Board Certified Emergency
Medicine Physicians with extensive training in occupational medicine.” (www.xstrememd.com)
The founder of XstremeMD, Dr. Joseph Pearson, who practiced
emergency medicine for 10 years in a community of oil and gas workers, had seen
countless patients coming into the ER with health problems that could’ve been
treated more easily if caught early. Along with the direct health consequences
of delayed care and misdiagnosis, there was also the expense. Not only were ER
visits expensive but many of these workers were being flown in from the oil
rigs they worked on at a cost of $60,000 a trip.
ISI was brought in to consult with XstremeMD back in 2010
due to their deep expertise in the telemedicine industry and their ability to
create custom technology solutions. XstremeMD knew that their challenge was to
connect their network of doctors with these patients who were in remote areas.
They also knew that telemedicine could be the solution but they needed
assistance with the execution.
Like a typical ER, patients could show up at all hours of
the day or night with a variety of illnesses that varied in seriousness. Just
like a hospital, the patients needed to be triaged or prioritized due to the
severity of their illness. Except, in this case, the triage would have to be
done in a virtual environment so that the workflow could be easily managed by
the doctors on-call. The doctors were
used to this system of assigning patients priority in the real world but doing
it digitally was different.
In addition, they wanted the solution to be user-friendly
enough that the oil rig workers could even use the machine themselves without
the assistance of an on-site medic or trained medical personnel. It was
important for the interface to have as few buttons as possible.
Given all of these challenges, the answer could not be an
out-of-the-box solution and would instead need to be a fully customized telemedicine
system unlike anything on the market.
Through a joint design effort between the team at XstremeMD
and ISI, they were able to develop the XMD Responder. This unit housed a PTZ
camera (pan, tilt, zoom), medical instruments for observation and diagnosis,
and color-coded medications all housed within a compact and mobile storage
device in case it needed to be moved to another room or different location. (XMD Responder)
The PTZ camera was also important because it allowed
the doctor to have control of the camera from the far-end. Therefore, if they
couldn’t see the patient at the proper angle, they could move and zoom in as
needed with minimal instruction to the patient. The other medical instruments
housed in the unit included a stethoscope, EKG, blood pressure monitor,
thermometer and otoscope. All of these readings could be transferred to the
doctor digitally so that he could have all of the same information he would
normally have as if he were in the room.
Another important aspect of the fully integrated solution was
the organization of the workflow. ISI had helped develop a similar workflow for
a previous client that they were able to apply to this situation. Here is how a
patient interacted with the portal from the moment they arrived:
- When a patient needs to see the doctor, they
enter the room with the XMD Responder and click one button on the remote that
places them in a “virtual waiting room.”
- Once in the waiting room, the doctor on-call
would in turn receive a call on all of his or her devices (PC, tablet, mobile
phone) notifying him that there is a patient that needs to see them.
- The doctor would accept the call and would see
the patient in the waiting room and would move them to a “virtual exam room”
which connects the doctor directly to the patient in a 1on1 call.
- The doctors can easily click and drag their
virtual presence from one exam room to another if a more severe case comes in
that needs to be addressed.
The benefit of this system is that it keeps all patients
separate at all times so that they are maintaining patient privacy while
balancing it with efficiency. Giving the patient a waiting room instead of just
letting the call ring until they reach a doctor allows the patient to be kept
at ease while also alerting the doctor allowing him to prioritize his patients
by their needs – just like they would do in a real hospital.
Troy Istre, General Manager of XstremeMD, had this to say
about his experience working with the ISI team on this unique project:
we were setting up our infrastructure, [ISI] helped us get up and running. The
guys...Brad Kirby and John Emery, those guys really are good. They work really
well with us. Anytime we have issues…they are there. It has been a great
Currently, ISI has helped deploy XstremeMD deploy
telemedicine units at 30 different sites including various oil rigs, on-shore
fracking locations, etc.
XstremeMD had a unique challenge and they knew technology
could overcome this challenge but they needed help to execute. ISI was able to
provide not only installation and support services but also acted as a
consultant by utilizing their vast experience in telemedicine to provide a
solution that was creative both from the technical and workflow aspects.