Today, children are able to receive good medical care either in their area or via a state-of-the-art telemedicine link to the Marcus Autism Center (www.marcus.org), a not-for-profit organization and subsidiary of Children’s HealthCare in Atlanta. The Center is able to provide care to more than 5,000 children with autism and related disorders.
The recently improved telemedicine system at the Center was initiated and funded by Georgia Tech Research Institute (GTRI) (http://gtri.gatech.edu) and Cisco Systems, Inc. (www.cisco.com) which donated $500,000 to fund equipment and software to improve the telemedicine system at both the Center and Children’s.
The Marcus Autism Center’s telemedicine room was redesigned to create telepresence and clinical workflow, so that that clinicians would be able to identify rural children with autism spectrum disorders as early as 18 months. Today, very often children are diagnosed as late as seven years old.
Felissa Goldstein, M.D a child and adolescent psychiatrist is the primary doctor using the improved telemedicine system at the Center. Until last summer, Goldstein had been using a telemedicine system in her office that had poor lighting, muffled sounds, and she was using displaced monitors which reduced eye contact. The GTRI systems engineers applied their expertise to Goldstein’s clinical setting.
Dr. Goldstein’s telemedicine system used two monitors side-by-side. The monitor on the left displayed medical records while the monitor on the right provided a view of the patients via a webcam atop the monitor. The engineers realized that a redesign of the monitors was necessary which did not require the doctor to turn their head or shift their gaze in an obvious way.
Today, the new telemedicine system is now in a room of its own with much better lighting and the monitors enabling food eye contact. The desk and monitors are now ergonomic and the room is soundproof. There is no longer an old fashioned webcam remote control which has been replaced by an iPad acting as the central control station for the telemedicine system.
Dr. Goldstein can tap the screen to control the camera. She can pan and zoom to follow children around the room as they play with toys or focus on the parents as they praise or discipline their children. The iPad can also do touchpad tagging of behavioral events that may occur during a session. If Goldstein needs to note a significant event, she can flag it in the system. She can later analyze the data to look for trends as to how symptoms develops over time.
Another improvement is the system’s ability to load unique settings for individual families plus Goldstein can share her screens remotely as she does when giving lectures. This feature can also be used to share educational materials with families during sessions as needed.
The engineering team is also in discussions with other funders for ways to use the system for different clients such as for teletraining, parent education, and dependent care in the military, however, these applications are still under development.