View Transcript
00:00:01:00 - 00:00:26:07
Tom Haederle
Welcome to Advancing Health. Here is a health statistic that hasn't changed in an amazing 75 years. Since 1950, cardiac issues, specifically heart disease, have remained the leading cause of death in the United States. But in Colorado, one hospital is using an innovative new tool to chip away at that stubborn reality.
00:00:26:10 - 00:00:49:06
Tom Haederle
I'm Tom Haederle, senior communications specialist with the American Hospital Association. Glad you can join us. And I'm also really pleased that Josh Neff could join us. Josh is president of Mercy Hospital in Durango, Colorado, an area of the state known as the Four Corners region, and is here today to talk about how Mercy is using a cutting edge communications tool called Pulsara to assist patients who are dealing with cardiac issues.
00:00:49:08 - 00:00:53:09
Tom Haederle
Josh, thank you so much for joining me on Advancing Health today. Really appreciate you being here.
00:00:53:12 - 00:00:59:11
Josh Neff
Yeah. Tom. it's a pleasure. It's a great opportunity to talk about some really great things we're doing in southern Colorado for cardiac care.
00:00:59:13 - 00:01:03:23
Tom Haederle
Well, let's start with the basics. What is Pulsara? And how is Mercy Hospital using it?
00:01:03:26 - 00:01:41:12
Josh Neff
So Pulsara is ultimately a field to hospital communication tool. And we've got a large and remote area. Sometimes our response times are lengthy in southern Colorado, especially in the Four Corners area we've got a lot of mountain passes. When it's, when it's snowy, it creates some really delayed times getting critical patients to the hospital. And so Pulsara is really a way for us to connect and communicate with our pre-hospital providers across our seven counties that we serve in southern Colorado and northern New Mexico, where for patients who are having chest pain and cardiac related issues, EMS has progressed over the last decade or two, and we've now got paramedics and other
00:01:41:12 - 00:01:58:10
Josh Neff
folks that are doing 12 lead EKGs in the field, as soon as they arrive at the patient. And that's a really important thing for us to know and understand. How do we get that EKG to a cardiologist that's at a hospital 20 or 30 miles away, or maybe more? And so Pulsara really bridges that gap for us.
00:01:58:13 - 00:02:29:26
Josh Neff
It allows those pre-hospital teams to transmit that EKG in a HIPAA compliant manner directly to the cardiologist on call. And that cardiologist then is able to help the pre-hospital team manage that patient clinically. That also allows us to be more prepared if that patient is actually having a STEMI or a heart attack. It allows us to have our teams ready and prepared so that that patient goes directly to the cath lab and undergoes cardiac treatment in a shorter period of time.
00:02:29:29 - 00:02:48:11
Tom Haederle
Take us inside the ambulance itself if you would for a minute. So you've got a patient in there who's having a cardiac issue enroute to the hospital. Could be a long drive ahead. What is happening in the ambulance itself and how are EKG and other vital signs - how is that all being monitored and transmitted? How does that happen?
00:02:48:13 - 00:03:13:21
Josh Neff
There's both Bluetooth and direct wired technology capability between. Basically it's transmitted over cell service. And even in the remote areas where cell service is a little bit patchy, the Pulsara system is accumulating this data in the background. And as soon as it hits a signal, it automatically transmits which allows that pre-hospital team, those paramedics and EMTs to be focused on working on that patient and providing care.
00:03:13:21 - 00:03:28:23
Josh Neff
As a former pre-hospital guy - so as a ground paramedic and a flight paramedic way back in the day - we didn't have this technology and it's really comforting for the team to be able to know that they've got a group of specialists just at their fingertips that can help us and help them care for that patient.
00:03:28:23 - 00:03:47:17
Josh Neff
And so basically, they get the machines hooked up. Pulsara can connect directly to their cardiac monitors. And so it feeds through that system and electronically can transmit a wide amount of data to us and to our caregivers that are that are at Mercy Hospital ready and waiting for that patient to come in.
00:03:47:20 - 00:03:53:03
Tom Haederle
And so what do they do with that information? Once it is transmitted? That helps with treatment plans?
00:03:53:03 - 00:04:10:08
Josh Neff
It does. So during the day, we've got our cath lab. We have two cath labs at Mercy Hospital. We're the only cath lab program in the southern part of the state and serving northern New Mexico. And so we've got folks on call or in the department every day. However, if it's after 5 or 6:00 at night, we've got an on call team.
00:04:10:10 - 00:04:30:13
Josh Neff
The goal is really with this to reduce the amount of time from first medical contact to device. And device is kind of that reperfusion or the treatment time that's tracked by all of the accrediting agencies. We know that the earlier we perfuse an artery, it leads to better outcomes. And that's both in-hospital mortality as well as long term recovery.
00:04:30:13 - 00:05:04:12
Josh Neff
And so what it allows us to do specifically at Mercy - before implementing Pulsara are we had about 130 minutes from first medical contact to reperfusion times. I mean, our cardiology team has worked with Los Pinos CMS, Pagosa Springs Hospital, Upper Piney EMS, all Durango Fire Department, and a number of other agencies. This year, since we've implemented Pulsara, we've been able to reduce that time from first medical contact to perfusion from 130 minutes to 84 minutes.
00:05:04:12 - 00:05:32:15
Josh Neff
So we've seen a 35% decrease in time, because typically what would happen is that patient would come to the ER, they'd have a repeat EKG, yes, you're having a STEMI. We should have the cardiac team here. You need to go to the cath lab. They'd have to, you know, drive in from where they were. And so what this has allowed us to do is our cardiologist directly receives this EKG on a cell phone, is able to interpret the EKG, and he or she makes the call in real time.
00:05:32:17 - 00:05:42:20
Josh Neff
This patient's having a STEMI. Hits the button, alerts our cardiac teams. And so that patient can come directly to the cath lab and undergo treatment immediately.
00:05:42:22 - 00:05:54:00
Tom Haederle
That's remarkable. And being able to shave that much time off from the older way of doing things prior to Pulsara, what kind of results has that yielded so far in terms of patient outcomes?
00:05:54:02 - 00:06:14:01
Josh Neff
So we know that that time is tissue. We are in the process of tracking the official data. What I can tell you anecdotally is we're seeing patients with shorter hospital stays getting back home and back to work and back to play in a shorter amount of time. And we're seeing better outcomes clinically for them as well.
00:06:14:06 - 00:06:26:07
Tom Haederle
That's just amazing. What kind of training is involved in using the Pulsara system, both for Mercy Hospital, ambulance employees, EMS people...is it a complicated thing to get the hang of, or not really?
00:06:26:10 - 00:06:46:21
Josh Neff
It is not. If you can operate your social media apps on your cell phone, you can understand and operate Pulsara. It is that simple. It's intuitive. It knows how to store the information, what to send. And so when those pre-hospital folks hit that send button, it just automatically alerts the team that's on the receiving end of it.
00:06:46:21 - 00:06:59:16
Josh Neff
So those folks who have the same Pulsara on their communication devices. They get an alert, they can go right in and tap the picture, look at the EKG. They can look at vital signs, a number of different things. So it is very easy to use.
00:06:59:19 - 00:07:05:26
Tom Haederle
What about the cost involved? Is that something that is within the budget, would you say, of many hospitals or health systems?
00:07:05:29 - 00:07:21:09
Josh Neff
Yeah, it is, it is not an overtly expensive investment. And it's an investment in clinical care and quality outcomes. So it made all the sense in the world for us to do it. We know that if we can save one life over the course of a period of time, then those investments are well worth it.
00:07:21:09 - 00:07:31:01
Josh Neff
But, I would say to any hospital CEO as well as the EMS programs that are out there, it is an affordable program that you can and you can easily integrate.
00:07:31:04 - 00:07:39:23
Tom Haederle
Would it be as helpful, do you think, for hospitals in more urban areas that really aren't looking at the same transport times, you know, with that patient in the ambulance?
00:07:39:26 - 00:07:57:02
Josh Neff
I think it could be used widely across all markets. I mean, I was in on the Denver Front Range before I moved to Durango. And, you know, it may take you 45 minutes to go 6 or 7 miles if you hit traffic wrong or there's a wreck. And so time is still tissue, and it's still important for those patients to receive timely care as well.
00:07:57:02 - 00:08:14:27
Josh Neff
And so it extends our ability for our cardiac specialists to have eyes and ears in the field, in the ambulance and understand what's going on with the patient. It allows our clinical teams to be thinking about, you know, what kind of STEMI does this look like? What should we be prepared for when this patient comes in the door?
00:08:15:00 - 00:08:34:02
Josh Neff
You can have a heart attack and still have pretty stable vital signs. You can also have a heart attack and be really, really sick with unstable vital signs. And so being able to communicate that to our team just allows them to mentally prepare for what's about to come through the door. You know, listen, I was doing pre-hospital care in the early and mid 90s
00:08:34:05 - 00:08:52:27
Josh Neff
And we didn't have this technology and we serviced some real markets. And, this would have been a game changer back then. I know for sure that this technology is saving lives and impacting the people who live and work in my community, and that's important to me. That's why I'm passionate about being the CEO of this hospital.
00:08:52:29 - 00:09:01:19
Josh Neff
That's our role in this world, is to make sure that we're taking great care of our community in a way that's meaningful, and this is just another tool in our toolbox that allows us to do that.
00:09:01:22 - 00:09:11:25
Tom Haederle
Well, thank you so much for your description of what it offers and how you're putting it to use. And, and thank you for the great care that you're offering your patients every single day. Really appreciate you being on Advancing Health today.
00:09:11:28 - 00:09:15:17
Josh Neff
Yeah, it's a pleasure. Thanks for asking us to talk about this.
00:09:15:19 - 00:09:24:01
Tom Haederle
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