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technology allows us to improve patient access to
recommended stroke treatments,” says Dr. Ali.
UCLA provides round-the-clock support to
18 hospitals in California that do not have
the resources and personnel to provide stroke
patients with timely assessments and emergency
stroke treatments. Initially launched in 2009, the
program now provides more than 150 neurology
consults each month.
“The key is having everyone know what needs
to be done during a stroke code,” Dr. Ali
explains. “We typically have a program leader at
each hospital to help us champion the program
and train staff on how to triage potential
Telemedicine is not limited to remote locations.
Virtual robot technology is also used to improve
efficiency within UCLA Health.
“Our intensive-care specialists often have to
manage crises 24/7,” says Neil A. Martin, MD,
chair of the Department of Neurosurgery. “Using
virtual-presence robots, they can examine and
manage patients remotely, which eliminates
delays in delivering care associated with traveling
to the hospital.”
Ronald Reagan UCLA Medical Center was the first
hospital in the world to introduce remote-presence
robots. The robot is approximately 5½ feet tall
with a flat-panel computer screen and camera at
its head. Physicians can remotely control the robot
using a joystick to make rounds at the intensive
care unit and have face-to-face discussions with
nurses at the bedside. The technology also extends
the capability of UCLA specialists to provide
consultation and training around the world.
“Some patients are more comfortable staying
in their own primary-care setting versus going
somewhere they don’t know much about,”
Dr. Slusser says. “Obesity management is
amenable to delivery via telemedicine because it
is primarily a counseling intervention.”
Each visit involves a physical examination
and presentation by the patient’s primary-care
physician, followed by consultation with
Dr. Slusser, a dietician and psychologist. Patients
are referred for physical therapy based on their
symptoms and physical exam.
“Many co-morbid conditions can get overlooked
in obese children, such as poor sleep hygiene
and obstructive sleep apnea, that may cause
kids to be hyperactive or overly sleepy during
the day,” Dr. Slusser says. “Telemedicine allows
us to bring our knowledge and expertise as
a multidisciplinary team to more patients
and then work collaboratively with their
primary-care physicians to unveil and address
“This technology eliminates
geography as a barrier
to anyone, anywhere
in the world.”
Despite its promise, telemedicine still faces
implementation challenges. Some hospitals
require consulting physicians to be credentialed
in the facility where the patient is being treated.
Additionally, some insurance payers cover
telemedicine services only in rural areas where
there are limited facilities available to patients.
Dr. Neil Martin, chair of the UCLA
Department of Neurosurgery, checks on a
patient remotely via an RP-6 mobile robot.
“This technology eliminates geography as a
barrier to anyone, anywhere in the world,”
Dr. Martin says.
For some patients, even short distances
represent insurmountable barriers to care.
UCLA pediatrician Wendy Slusser, MD,
uses telemedicine to provide monthly,
multidisciplinary childhood-obesity management
for low-income patients at the Venice Family
Clinic in Los Angeles. She is working to expand
the program to include the Los Angeles Unified
5 UCLA Physicians Update