Lopez-Magallon Archives

New robot helps care for kids in the emergency room at Children’s National Hospital

April 6, 2021

The robot, which is part of the FCC-funded COVID-19 Telehealth Program at Children’s National, is the latest innovation of the program that has rapidly evolved due to the ongoing pandemic.

Children and families who come into the emergency room at Children’s National Hospital may be surprised when their doctor comes in – in the form of a robot. Children’s National introduced a new robot to its Emergency Department (ED) for patients under evaluation for a COVID infection or being treated for other conditions. The robot, which is part of the FCC-funded COVID-19 Telehealth Program at Children’s National, is the latest innovation of the program that has rapidly evolved due to the ongoing pandemic.

“The robot can move in and out of spaces that otherwise we couldn’t get a significant number of providers in, especially with COVID-19 restrictions in place,” said Shireen Atabaki, M.D., M.P.H., associate medical director of Telemedicine, emergency medicine physician and program director for the COVID-19 Telehealth Program at Children’s National. “This is a really exciting program and it implements innovation that we might not have been able to do without the insights we’ve gained from the pandemic.”

The robot is Wi-Fi-enabled and can be remotely controlled by the physician providing the teleconsultation to monitor patient vitals — such as heart rate, body temperature or respiration rate. This allows doctors to work virtually with their team while also having the flexibility to attend to patients faster.

“The pandemic has made us aware of the need to protect patients, families and staff from infectious diseases,” said Alejandro Jose Lopez-Magallon, M.D., medical director of Telemedicine at Children’s National. The robot, he noted, spares clinicians from having to change their PPE, which saves time and gives them the ability to move on to the next patient while nurses and staff continue to provide bedside care.

“We have also seen that whenever a remote clinician is completely alone in the command center and can get on-screen without a mask, in a paradoxical way our patients may be more accepting of seeing a face on a screen that’s not covered with a mask and shield than a stranger using a mask in the same room,” Dr. Lopez-Magallon added.

Soon, the robot will also be used to coordinate subspecialty care — such as cardiac care — in the ED. This will provide more streamlined and expedited care for patients. Instead of leaving with a referral to set up a follow-up appointment with a specialist, patients would be able to receive the consult they need during the same appointment.

The robot is also presenting promising solutions for concerns around the number of restricted visitors. The team at Children’s National recently piloted using an iPad and other technology purchased with the FCC funds to remotely connect family members with patients.

“We downloaded the Zoom app to iPads in our ED to be able to coordinate calls between family members who can’t come in and see patients,” said Dr. Atabaki. “We are looking to implement this as a permanent solution keeping in mind how burdensome and emotionally stressful it has been for many not having the ability to be by the loved one’s side during such a challenging time.”

The FCC funds also covered the telehealth carts, tablets and other connected devices, the telehealth platform, telehealth equipment and innovative AI (augmented intelligence) to treat seriously ill COVID-19 pediatric patients.

The emergency department robot brings the robot-fleet at Children’s National up to three. The first robot was debuted in 2019 to serve children and families in the Cardiac Intensive Care Unit.

Acting FCC chairwoman Rosenworcel highlights telehealth for pediatrics

February 3, 2021

FCC Chairwoman Jessica Rosenworcel visited Children’s National Hospital

Acting FCC Chairwoman Jessica Rosenworcel visited Children’s National Hospital yesterday to highlight the importance of connectivity in healthcare and learn more about how the hospital is using telehealth to serve families during the pandemic. Children’s National Hospital in Washington, D.C., has provided pediatric care for 150 years and is among the nation’s top 10 children’s hospitals. Last year, Children’s National, an academic pediatric health system, saw more than 219,000 children from the capital region and from across the country and around the world.

“So much more can be done to connect children and their families — in both urban and rural parts of the country — to the care they need not only to survive, but to thrive,” said Rosenworcel. “Telehealth can help bridge that gap by bringing specialty care available only in hospital centers to smaller clinics and even the home where problems can be addressed quickly, before they prove life threatening. I was encouraged by the creative work that Children’s National Hospital is doing to address the unique health needs of children from all backgrounds especially during these challenging times.”

Acting Chairwoman Rosenworcel was joined by her colleague FCC Commissioner Nathan Simington for a tour of the hospital, where they met with Shireen Atabaki, M.D., M.P.H., associate medical director of Telehealth, Emergency Medicine physician and program director for the COVID-19 Telehealth Program at Children’s National Hospital. The visit also included a demo of a telehealth robot by Ricardo Munoz, M.D., Cardiac Critical Care Medicine chief, and Alejandro Jose Lopez-Magallon, M.D., medical director of Telemedicine, both at Children’s National.

“The pandemic catapulted telehealth as a tool for the future of health care delivery,” said Dr. Atabaki. “With the support of the FCC, Children’s National is excited to introduce a robot and other state-of-the-art digital health technology to support provider-to-patient pediatric care and expert consultations in our hospital’s emergency departments and across our region. These innovations in telemedicine will facilitate access to specialized expertise and care of COVID-19 patients.”

In May 2020, Children’s National Hospital was approved for funding as part of the FCC’s COVID-19 Telehealth Program and established a regional pediatric telehealth consortium. This will enable the hospital to expand its telehealth platform to support 15 health care sites in the region serving children and young adults, providing care to children with COVID-19, as well as those who are medically vulnerable.

Acting Chairwoman Rosenworcel is committed to closing the digital divide and sees access to telehealth care services — especially for underserved and marginalized communities — as a top priority. To learn more about telehealth efforts at the FCC, including the COVID-19 Telehealth Program and the Connected Care Pilot Program, visit: https://www.fcc.gov/connecting-americans-health-care.

Telehealth and AI reduce cardiac arrest in the cardiac ICU

July 14, 2020

The telehealth command center located a few steps away from the cardiac ICU at Children’s National Hospital.

The cardiac critical care team at Children’s National Hospital has developed an innovative Tele-Cardiac Critical Care model aiming to keep constant watch over the most fragile children with critical heart disease in the cardiac ICU. The system combines traditional remote monitoring and video surveillance with an artificial intelligence algorithm trained to flag early warning signs that a critically ill infant may suffer a serious event like cardiac arrest while recovering from complex cardiac surgery. This second set of eyes helps bedside teams improve patient safety and quality of care.

These high risk post-operative patients are often neonates or small infants born with the most complex and critical congenital heart diseases that require surgery or interventional cardiac catheterization in their first days or weeks of life. At these early stages after crucial cardiac surgery, these patients can decompensate dangerously fast with few outward physical symptoms.

The AI algorithm (T3) monitors miniscule changes in oxygen delivery and identifies any mismatch with a child’s oxygen needs. It also tracks and displays small changes in vital sign trends that could lead to a serious complication. The cardiac ICU command center staff then analyzes additional patient data and alerts the bedside team whenever needed.

The Tele-Cardiac Critical Care program started two years ago. In that time, the program has contributed to a significant decrease in post-operative cardiac arrest for this patient population.

“It’s easy to see how a model like this could be adapted to other critical care scenarios, including our other intensive care units and even to adult units,” says Ricardo Munoz, M.D., chief of Cardiac Critical Care and executive director of Telehealth. It allows the physicians and nurses to keep constant watch over these fragile patients without requiring a physician to monitor every heartbeat in person for every patient at every hour of the day to maintain optimal outcomes for all of them.”

Dr. Munoz and Alejandro Lopez-Magallon, M.D., medical director of Telehealth and cardiac critical care specialist, presented data from the pilot program at the American Telemedicine Association’s virtual Annual Meeting on June 26, 2020.

Advances in telemedicine start with new cardiac critical care robot

February 15, 2019

Dr. Bear Bot’s “robot-only” parking space in the Cardiac ICU. Alejandro Lopez-Magallon, M.D., is featured on the robot display screen, where he drives the robot from his location in the command center, in order to visit patient rooms and capture additional medical information and connect with patients, parents, and attending nurses and physicians.

The telemedicine robot at Children’s National arrived in late August 2018 and recently completed a 90-day test period in the tele-cardiac intensive care unit (cardiac ICU) at Children’s National. The bot travels between rooms as a virtual liaison connecting patients and attending nurses and physicians with Ricardo Munoz, M.D., executive director of the telemedicine program and the division chief of critical cardiac care, and Alejandro Lopez-Magallon, M.D., a cardiologist and medical director of the telemedicine program.

Drs. Munoz and Lopez-Magallon use a nine-screen virtual command center to remotely monitor patient vitals, especially for infants and children who are recovering from congenital heart surgery, flown in for an emergency diagnostic procedure, such as a catheterization, or who are in the process of receiving a heart or kidney transplant. Instead of traveling to individual rooms to check in on the status of one patient, the doctors can now monitor multiple patients simultaneously, enhancing their ability to diagnose, care for and intervene during critical events.

If Drs. Munoz or Lopez-Magallon need to take an X-ray or further examine a patient, they drive the robot from its ‘robot-only’ parking space adjacent to the nurse’s station, and connect with attending doctors and nurses in the teaming area. The onsite clinicians accompany one of the telemedicine doctors, both of whom remain in the command center but appear virtually on the robot’s display screen, to the patient’s room to capture additional medical information and to connect with patients and families.

Over time, the telemedicine team will measure models of efficiency in the tele-cardiac ICU, such as through-put, care coordination, and standards of safety, quality and care, measured by quality of life and short- and long-term patient health outcomes. This test run will serve as a model for future command centers offering remote critical care.

Ricardo Munoz and Alejandro Lopez-Magallon

(R) Ricardo Munoz, M.D., executive director of the telemedicine program and the division chief of critical cardiac care, and Alejandro Lopez-Magallon, M.D., a cardiologist and the associate medical director of the telemedicine program in the tele-cardiac ICU command center.

“As technology and medicine advance, so do our models of telemedicine, which we call virtual care,” says Shireen Atabaki, M.D., M.P.H., an emergency medicine physician at Children’s National, who manages an ambulatory virtual health program, which enables patients to use virtual health platforms to connect with doctors, but from the comfort of their home. “We find the patient-centered platforms and this new technology saves families’ time and we’re looking forward to studying internal models to see how this can help our doctors, enabling us to do even more.”

The ongoing virtual connection program that Dr. Atabaki references launched in spring 2016 and has enabled 900 children to connect to a doctor from a computer, tablet or smart phone, which has saved families 1,600 driving hours and more than 41,000 miles over a two-year period. Through this program, virtual care is provided to children in our region by 20 subspecialists, including cardiologists, dermatologists, neurologists, urgent care doctors, geneticists, gastroenterologists and endocrinologists.

To extend the benefits of virtual communication, while saving mileage and time, Dr. Atabaki and the telemedicine team at Children’s National will partner with K-12 school systems, local hospitals and health centers and global health systems.

The Children’s National robot was named Dr. Bear Bot after a 21-day voting period with patients and staff, beating 14 other child-selected names, including SMARTy (Special Medical Access to Remote Technology), Dr. Bot and Rosie. Dr. Bear Bot celebrated with an official reveal party on Valentine’s Day, which was streamed to over 220 patients through the hospital’s closed-circuit television and radio station.

Tag Archive for: Lopez-Magallon