Validating Virtual Coma Care

March 30, 2017 by InTouch Health

A new study was recently released showing that doctors can assess coma patients via telehealth just as effectively as those at the bedside.

The 15-month study involved about 100 patients in varying levels of coma. Two neurologists (one remote, one at the bedside) assessed the patients using two leading metrics: the Glasgow Coma Scale (GCS) and the Full Outline of UnResponsiveness (FOUR) score. Both scales measure things like eye and verbal response – and the FOUR score also assesses brain stem reflexes and respiration. In both assessments, the differences between the bedside and remote scoring were minuscule.

Full results of the study were published earlier this year in Telemedicine and e-Health journal. In the abstract, Dr. Bart Demaerschalk concludes that “by establishing a telemedicine platform in the ICU, patients with a decreased level of consciousness or those in a coma can be triaged and assigned a care management plan more quickly.” Demaerschalk’s team is now planning to study telehealth’s efficacy in assessing brain death – a diagnosis that must adhere to strict guidelines.

Many patients enter a coma following high-severity traumatic brain injuries (TBIs). According to the Centers for Disease Control and Prevention, the cost of TBIs requiring hospitalization account for about 90% of total TBI medical costs.

“This study suggests yet another way telehealth can enhance patient care,” says Amelia Adcock, MD, a co-author of the study. “There is a shortage of intensive care unit providers and facilities with round-the-clock patient coverage. Telehealth can provide a way to ameliorate this shortage and improve early evaluation of critically ill patients.”