By Laura Dawahare

Somewhere in Kentucky, a patient checks in at the front desk of her local hospital’s memory or behavioral health clinic. The patient is concerned she may be having memory problems and, at the encouragement of family and friends, has booked an evaluation. A nurse greets the patient and takes her into an exam room.

Suddenly the doctor is there – but he doesn’t enter via the door. Instead, a computer monitor in the room snaps to life and the face of Dr. Greg Jicha, neurologist at the University of Kentucky Sanders-Brown Center on Aging, appears. Jicha, who works with Alzheimer’s and related cognitive disorders, is in Lexington but he is about to examine his patient through a system facilitated by Kentucky TeleCare at the University of Kentucky.

Jicha greets the patient, asks her several questions about her memory, and puts her through some simple diagnostic tests. He can see the patient’s face, just as she can see his. The telemedicine equipment and software allows Jicha and the patient to interact face-to-face and in real time, having a conversation just as if they were sitting only inches apart. The nurse stays with the patient the entire time, observing and offering assistance when needed.

Once the formal evaluation is complete, Jicha talks with the patient about her results and about why she may be having trouble with memory. After the appointment is over, he contacts the patient’s hometown doctor to discuss whether she needs further diagnostic tests, and to consult about the best treatment plan possible for their patient.

Origins of Telemedicine

Telemedicine was conceived as a way to extend scarce clinical resources from the academic medical center to rural communities in a cost-effective manner and has been used successfully for more than 20 medicine specialties at the University of Kentucky. The Sanders-Brown program allows doctors at participating facilities to easily arrange consultations with world-renowned experts in Alzheimer’s and memory disorders, adding the latest expertise to a patient’s care team without having to travel too far from home to be seen.

“State-of-the-art memory evaluations should not be available only to the people able to make a trip to Lexington,” said Jicha, who notes that people with memory disorders are sometimes anxious about travelling or being in unfamiliar places, which can make the trip frightening for the patient and trying for the loved ones who accompany them.

“Taking advantage of internet technologies to bring expert care into even the smallest of rural communities is a blessing for many families across Kentucky who simply cannot bring a loved one with dementia to Lexington.”

The Sanders-Brown/Kentucky TeleCare clinical outreach program began in 2005, when a patient from Olive Hill needed to be seen but refused to travel to Lexington for her appointment.

The patient’s daughter-in-law, a nurse at St. Claire hospital, was certain she could persuade her mother-in-law to come to Morehead for an appointment, so she contacted Kentucky TeleCare’s director Rob Sprang to see about the possibility of using the TeleHealth equipment. The virtual appointment was awkward for both until Jicha – known for his rapport with patients – broke the ice, saying, “Wow, you look like a movie star on the TV!”

Jicha cared for her for over a decade. Jicha recognized immediately that telemedicine was an effective way to deliver expert care to patients outside of Lexington, and the program became a fixture on the TeleHealth schedule.

This scene takes place several times a month, as physicians affiliated with the Sanders-Brown Center on Aging use telemedicine to work with healthcare professionals and patients regularly at more than a dozen healthcare facilities around the state, and even more upon request.

“Optimizing care for a person with memory loss requires teamwork,” said Jicha. “The trusting relationship between a patient with dementia and their hometown doctor is the foundation for an entire care team that incorporates the resources at the Sanders-Brown Center on Aging.”

 

Advancing discoveries for age-related disease

In 1985, the University of Kentucky Sanders-Brown Center on Aging (SBCoA) was among the first 10 Alzheimer’s Disease Centers funded by the National Institutes of Health, and has been continuously funded ever since.

Research participation is essential to advancing knowledge of diseases and identifying potential treatments. Sanders-Brown sponsors numerous studies that explore age-related brain disorders and promote healthy aging.

There are participation opportunities for people with Alzheimer’s or other dementias, and for people at risk for those diseases but without symptoms. Healthy volunteers are always needed. Participation is open to persons of all genders, racial backgrounds, and ethnicities.

Current Sanders-Brown studies are investigating a range treatment and prevention approaches, including supplements for brain health, impacts of medication, exercise, and new medications related to Alzheimer’s disease and cognitive impairment.

–Laura Dawahare is the senior public relations specialist at the University of Kentucky.