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Connecting Minds…From the Field to the Future

Connecting Minds…From the Field to the Future. Dr. Chadley Runyan M.D. McLeod Orthopedics Dr. Adam Ploeg Ed.D , ATC Director of McLeod Sports Medicine. Disclosures. We have no relevant financial interests or conflicts to disclose. Overview. Background:

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Connecting Minds…From the Field to the Future

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  1. Connecting Minds…From the Field to the Future Dr. ChadleyRunyan M.D. McLeod Orthopedics Dr. Adam Ploeg Ed.D, ATC Director of McLeod Sports Medicine

  2. Disclosures We have no relevant financial interests or conflicts to disclose

  3. Overview Background: What is a concussion and how is it treated? 2 approaches School to MD office School to ATC

  4. Definitions Sports related concussion is a traumatic brain injury induced by biomechanical forces Direct blow or indirect blow Rapid onset of symptoms **Typically May result in neuropathological changes…generally a functional disturbance and not a structural issue Range of clinical signs and symptoms. Typically the follow a sequential course.

  5. Incidence According to statistics some 3.8 million recreational and athletic concussions occur each year in the United States, with children under the ages of 15 accounting for the most ER visits for traumatic brain injury. Meanwhile, 65 percent of public high schools don’t have a full-time athletic trainer who could diagnose a concussion on-site. https://mhealthintelligence.com/news/telemedicine-gets-a-passing-grade-in-school-concussion-study

  6. McLeod Sports Medicine Outreach Program with local schools and universities Over 25 athletic trainers Present for games, practices, other events Coordinate baseline testing and correlate with pre-participation exam Initial evaluation of injuries, rehab as needed Return to play protocol/process

  7. Team Approach ATC and Provider must work in conjunction with each other Initiate and administer immediate care Coordination of evaluation (per state law) Communication with athletes/family/provider

  8. Concussion Management Injury Assessment by ATC Emergency Department, if indicated Physician evaluation Symptom report Examination Provocative testing Neuro-cognitive testing Treatment recommendations Protect from further injury Academic modifications

  9. Concussion Management Follow-up evaluation Symptom report Examination Provocative testing Neuro-cognitive testing Treatment recommendations Continue restrictions Advance activity and return to play (RTP) RTP protocol Supervised by ATC Release to full activity, or follow-up if indicated

  10. The Numbers 2016-17 School year (August) 91 individuals 241 office visits 2017-18 School year to date (4 months to remaining) 134 Individuals 296 Office visits

  11. New Technology  New Options Telemedicine Grants for implementation McLeod Foundation South Carolina Telehealth Alliance Benefits Improve access to care Decrease travel Costs, time, missed work, missed school, etc Expand service area/footprint  Rural

  12. Technology • Our program utilizes several methods while providing assistance to our athletes • Iron Bow • VGo

  13. New Approaches Office visits Telemedicine Hybrid

  14. Office Visit Follow up scheduled at MD office for initial visit Subsequent visits performed via telehealth In some cases more detailed visits are necessary to rule out major complications

  15. Telemedicine Follow-up visits Assessment by ATC Symptoms Exam if necessary Neuro-cognitive testing Clinical decision Release to full activity

  16. Hurdles/Barriers It’s new! Can be technical, however ease of use has gotten better Infrastructure Security Cost? Resources/space Reimbursement  billing codes, new to payors, etc.

  17. Solutions Team Approach McLeod has a team dedicated to expanding the utilization of telemedicine IS and Sports Medicine …experience and creativity Improve care for our patients

  18. Next Steps Increase number of follow ups Increase number of units in place Increase ease of technology Increasing our footprint/deployment Sideline? Injury Checks? On-call? ATCs and MDs

  19. Questions? Dr. ChadleyRunyan chadley.runyan@mcleodhealth.org Dr. Adam Ploeg aploeg@mcleodhealth.org

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