GMHA using breakthrough telemedicine technology to ‘bring’ ICU doctors to Guam

Telemedicine began with GMH's very own Pulmonary and Critical Care physician, Dr. Joleen Aguon. (GMH photo)

As part of Guam Memorial Hospital Authority’s relentless pursuit to provide excellent, accessible healthcare to our island, the hospital has been leading the way in utilizing
telemedicine critical care physicians (intensivist) based stateside to ensure around-the-clock care for the sickest patients.

What was born out of necessity during the COVID-19 pandemic has now become a staple feature in our Intensive Care Unit (ICU).

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Telemedicine began with our very own Pulmonary and Critical Care physician, Dr. Joleen Aguon. At the height of our grapple with COVID’s second wave, GMHA had so many virus-stricken patients needing her specialization in lung care, the only way to make it happen was through technology. Through the incredible work of our IT and clinical informatics team, led by Paula Manzon, interdisciplinary teams began taking iPads around to patients all over the hospital to bring in Dr. Aguon virtually.

Dr. Aguon would bring her expertise into the collaborative conversation with the patient’s attending physicians, nurses, pharmacists, techs, and others in order to ensure the highest standards of patient care. These standards were born out of GMHA’s Clinical Emergency Preparedness Team (CEPT), which was gathering real-time, ever-changing data, from around the world, to manage this deadly virus.

This iPad technology then grew to include Dr. Michael Switzer and Dr. Garrett Britton, both Department of Defense physicians who practiced at GMHA as part of the DoD effort last fall to support GMHA’s COVID-battle. When they left the island after their 30-day tour at Guam’s trusted public hospital, Dr. Switzer, a Pulmonary and Critical Care Physician, along with Dr. Britton, a Critical Care Physician, began to take shifts on the iPad technology to support the interdisciplinary team caring for ICU patients at GMHA.

It became quickly apparent that telemedicine was an innovative tool, availing the most critical patients of specialized care around-the-clock.

“Although COVID was, and still is, a hard-fought battle, telemedicine is one of the few silver linings. This virus pushed us at GMHA beyond our limits and beyond anything we thought was possible. Through this push, we broke barriers to medical care and found these incredible opportunities and talents that will forever improve our bedside care for our community,” said Dr. Joleen M. Aguon, Pulmonary & Critical Care Physician, COVID Medical Director and Associate Administrator of Clinical Services.

GMHA’s telemedicine program has grown to include a ROUNDER2 telemedicine system that uses a hi-definition television. The ROUNDER delivers the physician life-size, 3D, and with direct eye-contact and includes the ability for real-time patient monitoring, including a stethoscope to listen to a patient’s heart and lungs, and a mobile camera to zoom into areas needing closer attention. This technology is courtesy of Innovator Health, a telemedicine company working to improve access to high-quality medical care for rural and underserved populations.

“When we launched Innovator Health, we had one mission and one mission only: break all barriers to high-quality healthcare. We know Guam is far and isolated. Knowing our nationally-recognized doctors can reach and treat GMHA’s most critical patients means that we’re fulfilling our mission. And that’s what all this is about…excellent patient care!” said Dr. Sommer, Innovator Health CEO.

The physicians appearing virtually at GMHA are supported by Telemedicine Technicians (teletechs), who act as the doctor’s hands and feet around the ICU. These are primarily pre-med students looking to gain more hospital experience before completing medical school. GMHA is shaping the knowledge and experience of our island’s future healthcare leaders, so they may serve our population for years to come.

“We know that attracting specialists to our island can be challenging, but at GMHA, that just fuels us to find new and innovative ways to get past this challenge. Our team has proven time and again that in the face of adversity, we will rise. And in the face of COVID, we rose! Telemedicine is the leading edge of healthcare and we’re proud to be bringing these capabilities to our island,” said Lillian Perez-Posadas, GMHA CEO.

There are currently 6 telemedicine doctors at GMHA who take shifts covering the ICU when Dr. Aguon (the primary intensivist) is off, mostly during evenings and weekends. The doctors stateside work with GMHA’s outstanding in-house ICU teams, spanning multiple disciplines to include the attending ICU hospitalist physicians, clinical pharmacists, nurses, respiratory therapists and other specializations to ensure the best care possible.

“Ultimately, we want our patients to recover and continue to live healthy lives; we are literally going to every corner of our nation to ensure that happens,” said Paula Manzon, Clinical Informatics Nurse Supervisor. “Where physical barriers stopped us, technology saved us and I’m so proud to lead the telemedicine team that makes all of this possible.”

While the telemedicine program is currently unique to the ICU, GMHA is exploring the opportunity of expanding to other specialty departments as well.

(GMHA Release)