Wednesday October 21, 2020

Bringing healthcare to the community at large

Portable medical imaging that comes to the patient is at the cutting edge of a massive change in how healthcare is delivered

17th October, 2020
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Dr John Sheehan, consultant radiologist, Mobile Medical Diagnostics

Moving equipment, not patients – it’s a simple idea, but one that is entirely new to delivery of X-rays to older patients in Ireland.

Discovering a need, initially for nursing home residents who frequently became confused by being brought to hospital, Mobile Medical Diagnostics is now bringing X-ray imaging to private residences.

“It’s a new, unique service utilising high-quality, digital portable technology that allows us to innovate and bring the equipment to the patient, rather than the patient to the equipment,” said consultant radiologist and clinical director of Mobile Medical Diagnostics and the Hermitage Medical Clinic, Radiology Department, Dr. John Sheehan.

Founded by Mary Jones, Mobile Medical Diagnostics is a first not only in Ireland, but also in the EU. In other countries such as Norway, mobile X-ray machines can be brought to nursing homes, but only Mobile Medical Diagnostics is licensed to operate in private homes.

Killian Lavelle, radiographer, with one of Mobile Medical Diagnostics’ X-ray machines

Sheehan said that Ireland is a highly innovative country which punches above its weight in areas such as literature, music, aviation and also in the medical sector.

“Our X-ray machine is fully digital, mobile, and it produces very high-quality X-rays. Importantly, it emits a very low dose of radiation,” said Sheehan.

The lightweight but robust machine can be brought directly to the patient’s bedside, following a request from a GP to diagnose or exclude fracture and infection, take X-rays post-surgery and to monitor chronic conditions.

“Common uses include chest X-rays or hip X-rays,” said Sheehan.

Image processing occurs on a laptop which is inbuilt on the X-ray machine and then, via a 4G modem, the image and the request card is sent to the cloud-based Patient Archiving Communication System (PACS).

“From there, a doctor, from a team of consultant radiologists working with Mobile Medical Diagnostics reviews the images on their diagnostic workstations. They issue a report within one to four hours, send it back to the cloud and then on to the referring doctor to enable further decisions on the patients management pathway,” he said.

“We have found that 85 per cent of patients are able to avoid an ultimate transfer to hospital for further care,” he said.

Infection control

In today’s world, of course, the coronavirus pandemic dominates all discussion of healthcare. Here too, mobile medical imaging can make a contribution to not only alleviating Infection Control concerns – few want to go to hospital right now – but even to relieving psychological pressures.

For example, a nursing home resident brought to the emergency department (ED) for an X-ray is now required to quarantine on their return.

“Having a patient quarantine within a nursing home for up to two weeks now further adds to the stress on these vulnerable people and their families, never mind the significant cost of PPE, which is required,” said Sheehan.

In effect, Mobile Medical Diagnostics is humanising healthcare by extending a patient-centric focus.

“Having such a huge impact on the community through such a simple service adaptation is very rewarding,” he said.

Sheehan believes this focus on meeting the patients needs is likely to be the future of medical care.

Moving away, where possible, from centralised hospital care to smaller specialist centres and even into the home not only reduces stress on patients and risk of infection, including Covid-19, it also frees-up vital resources in the hospitals and saves money.

“As the LetsGetChecked founder Peter Foley said this week: ‘We used to go to the cinema, now we have Netflix at home.’ It’s so easy and healthcare should be the same.

“The future of healthcare is not only in hospitals, it’s expanding into the community,” said Sheehan.

As for the immediate future, Mobile Medical Diagnostics hopes to engage with the HSE and to start using BEAM (a data exchange solution) provided by Change Healthcare, which provides and manages the HSE’s NIMIS (National Integrated Medical Imaging System) network.

“This would allow seamless co-operation and integration between the HSE and private healthcare diagnostic services, resulting in efficiency and effectiveness of healthcare delivery in the community for patients and GPs,” said Sheahan.

“Our service is very efficient and patient-centred. Hopefully the increased Sláintecare budget will permit funds to be allocated for mobile X-ray in nursing homes and the wider community, enabling delivery of the Sláintecare vision of the right care, in the right place, at the right time.

“This is an exciting new way of delivering healthcare in the community.”

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