Telemedicine — also known as telehealth — is a virtual service that allows patients to have a one-on-one conversation or consultation with a provider or specialist remotely. Much like an in-person visit, telehealth facilitates the exchange of care, advice, reminders, education, intervention, monitoring and remote admissions from the clinician to the patient. Depending on the case, telehealth appointments can be conducted in a physician’s office, hospital or even in the comfort of the patient’s home.
The advent of the COVID-19 pandemic saw a dramatic rise in the use of telehealth services. However, the benefits of telehealth have extended well beyond its value throughout the pandemic.
The family of Farmington, Mo. resident, Howard “Crockey” Peterson, 84, knows those benefits firsthand. Back in October 2023, Crockey’s wife, Kathryn Peterson, brought her husband to Parkland Health Center after noticing that he seemed more disoriented than usual. Crockey’s son, Chip Peterson, was equally concerned.
“Like many people in their eighties, my dad had recently shown more signs of slowing down as well as dementia,” said Chip. “However, he was non-responsive, started sleeping a lot more and seemed generally out of sorts. We were concerned but couldn’t figure out what was wrong.”
When Crockey arrived at Parkland Health Center, the emergency department staff assessed him, took his vitals, and conducted some diagnostic tests. His vitals were concerning and there were early signs of kidney failure, so he was admitted to the hospital on October 9, 2023. The medical team, which included both internists and hospitalists, advised Kathryn and Chip that Crockey would need a neurological assessment under the care of a specialist.
“We were pretty worried at that point,” said Chip. "Because he was so fragile, our greatest fear was that he would need to be transferred to Barnes-Jewish Hospital in St. Louis for advanced treatment. At that point, I didn't think he could handle the stress of having to be moved."
Much to his surprise, Chip learned that Crockey could undergo a neurological assessment with a Barnes-Jewish neuro specialist via telehealth. In other words, he wouldn’t have to be transported and could rest comfortably in his hospital bed during the consultation.
“We were all thrilled Parkland Health Center offered this neuro telehealth option to us,” said Chip. “It was truly a gift, especially for my mom, who was stressed about my dad’s condition and didn’t want to leave his side.”
As part of BJC HealthCare, Parkland Health Center is home to some of the region’s best physicians, providing patients access to the latest innovative technology and expertise close to home. Understanding how taxing it can be on patients to have to travel for medical appointments with specialists, the hospital offers convenient options like telehealth consults in certain cases to help alleviate some of that added stress.
“I love being able to help and see patients in their — and my — hometown to keep them from having to be shipped to another hospital, if at all possible,” said Ross Quinton, DNP, FNP, a board-certified nurse practitioner specializing in neurology at Parkland Health Center. “Streamlining care and being able to help the people I live with is profoundly rewarding. Having the extra assistance from my collaborators through teleneurology [AW1] is another way we can increase access to neurological care here at Parkland Health Center.”
With Quinton by their side, Chip and his family met with James F. Alonso, MD, a BJC Medical Group neurologist at Missouri Baptist Medical Center, for a teleneurology visit at Crockey’s bedside. For the next 20 minutes, Chip outlined the various symptoms and concerns he and his family had about Crockey, and then answered a series of questions Dr. Alonso posed.
“When we went into that virtual consult, we didn’t know how it would go. Immediately, it was clear we would find an answer and have a plan,” said Chip. “The one-on-one compassion and quality of care that Dr. Alonso delivered was incredible. He was thorough and engaging, while putting us — particularly my mom — at ease.”
Ultimately, Chip’s detailed summary combined with an MRI of Crockey’s brain led to a diagnosis of metabolic encephalopathy. This is a condition caused by a chemical imbalance in the blood that occurs due to an illness or the body’s organ not working as well as they should. When the imbalance affects the brain, as in Crockey’s case, normal thinking and behavior can change.
“Metabolic encephalopathy is a diagnosis that happens a lot with older patients, especially patients who are starting to have underlying issues with cognitive decline. Additionally, it doesn’t take much to become encephalopathic — issues such as medication mismanagement, urinary tract infection or acute illness can trigger it,” said Quinton. “Usually, once the underlying problem is resolved, the encephalopathy eventually resolves as well. It’s absolutely something that anyone who’s caring for their elderly loved ones should be aware of.”
By the end of the day, Dr. Alonso and Quinton collaborated to create a treatment plan for Crockey. His family was relieved and optimistic to have some answers and a plan in place so quickly. Crockey would spend the next few days at Parkland Health Center, where he was continuously monitored until his symptoms resolved. He was then discharged to a nursing home, where he recovered for the next two weeks before going home.
“My dad is doing remarkably well since being treated for his metabolic encephalopathy,” said Chip. “I whole-heartedly believe he would’ve died without that telehealth consult. We’re lucky to have the type of quality medical care Parkland Health Center offers to our community. They can handle most medical situations and have the support of BJC HealthCare when needed.”
For more information about the telehealth services available at Parkland Health Center, call (573) 431-3338.