The mountains and plains of Colorado are a magnet for skiers, bikers and extreme-sports enthusiasts. Accidents are bound to happen, often far from medical specialists with the expertise to treat injuries such as concussions.
To address that reality, Centura Health, a system based in Englewood, Colo., has added a teleconcussion program in four rural Colorado areas. Using two-way audio and visual communication, the program gives primary care physicians access to expert secondary opinions about individuals who have or may have suffered concussions. It also assists with concussion management and prevention advice for coaches of young athletes.
“The reality is that patients don’t have the time or resources to drive an hour or two to get that secondary type of consultation,” says Samantha Lippolis, Centura Health’s director of telehealth.
Rocky Khosla, M.D., a family doctor in southern Colorado’s Centura Health Physician Group, developed the program. He’s been interested in concussion treatment since the early 1980s but has witnessed an explosion of related information and technology over the last five years.
In 2011, Khosla set up a concussion management program at St. Mary-Corwin Medical Center in Pueblo, Colo., that works with kids in sports like football and hockey. A year later, Colorado passed a law that requires coaches to receive education and have a plan in place to treat concussion victims. Jennifer Kagan, a trauma and emergency department nurse in Frisco, Colo., helped Khosla expand the teleconcussion program for rural areas.
To illustrate how the program works, Khosla describes a hockey player in Frisco who was still exhibiting symptoms three weeks after his third concussion. The player’s primary physician knew he needed more advice.
Kagan gave the patient a nine-page questionnaire about his mood changes, depression and other symptoms, and shared the responses with Khosla. During the telehealth visit, Khosla could watch Kagan and the patient from a monitor in his office. He directed Kagan to perform parts of the physical exam and was able to see the patient’s expressions and reactions.
Khosla says teleconcussion care could expand beyond the medical exam room, assisting coaches during football games and in locker rooms after a player suffers a concussion.
“It’s not that you get one concussion. It’s that you get repetitive concussions over and over because you weren’t properly managed after your first,” says Lippolis.