Monday, February 27, 2017

Technological advances in the hands of a gifted team result in saved lives

By: Yung Lau, M.D.
UAB Professor and Director, Division of Pediatric Cardiology

Thanks to improved technology, pediatric cardiologists at Children’s of Alabama are seeing improved survival rates in children with hypoplastic left heart syndrome and other critical heart conditions.

Hypoplastic left heart syndrome, or the condition of babies born with only one ventricle, is a condition requiring surgery at birth, at 4 to 6 months, and again at 3 to 5 years of age. We discovered that a certain percentage of babies between the first two surgeries could be expected to die suddenly at home.

As a result, Children’s launched Hearts at Home, a program intended to help parents and physicians work together using remote technology to improve that percentage of inter-stage mortality.

With software by Vivify Health, physicians can monitor a child’s condition through a HIPAA-compliant secure system. Parents are provided with a tablet and Vivify’s proprietary software that enables them to enter information such as weight, weight gain and oxygen saturation. That information, along with graphs and trends, is uploaded to physicians. The camera on the tablet even allows practitioners to view the child when a parent is concerned in order to assess whether he needs to come to the hospital.

Another technology, AirStrip ONE, allows us to monitor patients in the hospital from anywhere in the world and consult more effectively with colleagues. With AirStrip ONE, physicians use the Internet and a simple app on their phone to see results from a hospital bedside monitor within five to 10 seconds. We can check on patients periodically, and when needed, we can enlist the support of colleagues for a consult, even when every participant is in a different location. Several eyes almost always mean improved care, as each team member looks at a different aspect of the data. For instance, when a cardiology intensivist recognizes that a particular incident may have been significant, she can ask a pediatric electrophysiologist to look at the rhythm at a particular point in time. The technology allows us to look at trends remotely and adjust our course of care accordingly. Thanks to AirStrip, we have been able to improve and save lives.

Of course, even the best technology is limited by the people who apply it, and the team at Children’s works together in impressive ways to apply these technological advances to make a difference in the lives of our patients. We are part of an organization, Children’s of Alabama, that is dedicated to the care of children. Supporting professionals from therapists to social workers to child life specialists to pharmacists on our team are all focused on forming a cohesive, multi-disciplinary team.

The results have been impressive. Nationally, the average mortality rate for all pediatric cardiac patients is 3.5 percent. Our Birmingham group’s mortality rate in 2015 was 1.6 percent, and that improved to .7 percent in 2016. In addition, while the national mortality rate for hypoplastic left heart syndrome is 8 percent, thanks to Hearts at Home and our team of surgeons, intensivists, cardiologists, anesthesiologists and supporting professionals, we had no deaths due to that condition in 2016.

That’s a result we can all live with.

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