Improving the Lives of Dialysis Patients in Rural Clinics

Nephrology is the subspecialty of internal medicine that focuses on the diagnosis and treatment of kidney diseases. And, like many other medical specialties, it’s facing a critical shortage of providers for a variety of reasons:

  • COVID-19 infections have increased the amount of kidney injuries in as many as 43% of patients in some hospitals, which in turn increases the demand for dialysis.
  • The increased demand has pushed providers and staff to their limits, resulting in even higher than usual turnover rates.
  • Dialysis specialists require extensive training and technical skills that can take months to learn.
  • Nephrologists and kidney specialists are increasingly located in urban areas, making it hard for people in rural settings to access them.

In Guatemala, there are over 230 patients receiving dialysis treatment in decentralized clinics located more than 200 kilometers away from the capital. These clinics are located in the municipalities of Cobán, Morales, and Zacapa and are more than three hours away from each other.

The clinics are staffed with technical assistants, nurses, and one internist on-site – but not enough specialists. Nephrologist Dr. Weynin Sierra is one nephrologist who travels weekly between the three clinics, spending several hours traveling. When the subject of using Hippo Virtual Care™ was broached, Dr. Sierra was eager to try it.

“Using the Hippo Virtual Care headset and platform will save us time, because right now, moving from one unit to another takes us 3-4 hours. This will help save us time, gasoline, and will allow us to expand our clinics,” he said.

Using Hippo Virtual Care, Dr. Sierra is able to conduct visits remotely by connecting with Dr. Byron Hernandez, an internist in Cobán who wears the hands-free voice-enabled headset during a patient examination, paired with our HIPAA-compliant virtual care software. Unlike traditional telehealth, Hippo Virtual Care provides a “U see what I see” perspective to the observer, as well as remote control functionality to orient the camera, allowing remote physicians to conduct an exam as if they were physically in the room.

For 30 minutes, Dr. Sierra is able to supervise the internist’s rounds – seeing, hearing, and speaking to his patients who are in a clinic 3-4 hours away – and deliver instructions to Dr. Hernandez in real time.

“Now that I was able to experience using the headset and the software … well, it really fulfills all my expectations. It’s an innovative system. It allows us to be with our patients in real time. It feels like you’re right there in the room with them."

Dr. Sierra

By incorporating next-generation virtual care into clinical practice, patients in rural areas like the decentralized clinics in Guatemala can more easily access the specialist care they need. Hippo is bringing a new dimension to telenephrology, allowing complex care to reach patients even when they’re far away from clinical specialists.

Learn more about Hippo Virtual Care™ and how it can save your team time, money, and increase the quality of care you give to your patients.

5G Telemedicine & Medical Training

The need for virtual care to service rural and remote locations is growing at a rapid rate around the world – even more so during the pandemic. The Royal Dutch Shell Hospital in Port Harcourt, Nigeria is revolutionizing both the healthcare delivery and teaching experience of its patients, clinicians, faculty, and students in sub-Saharan Africa by leveraging several of Hippo’s virtual care solutions.

What was implemented

TEACHING IN ADVANCE OF PATIENT CARE
Hippo Virtual Medical Education™
While teaching in clinical practice inevitably occurs during rounding, consultations, and proctoring, it is also critical prior to caring for patients, especially for sub-specialty care such as neurology or neuroscience. Using Hippo’s voice-activated hands-free headset, faculty are able to teach important processes and procedures which can then be incorporated during patient care.

SUPPORT FOR ATTENDING PHYSICIANS
Hippo Virtual Consultation™
Attending clinicians are being supported remotely by specialists as they assess and provide direct care for patients in the hospital and in outpatient clinic settings. Hippo provides a unique “you are there” perspective which enables complete physical examination and interview, and direct viewing of devices, vital signs and laboratory results.

BEDSIDE SUPPORT FOR CLINICIANS
Hippo Virtual Rounding™
Inpatients are being remotely assessed by a senior physician on a routine basis to support clinicians at the bedside. This is especially critical when it comes to post-operative care or with critically ill patients. Students are also participating in virtual rounding – an essential part of the clinical learning process.

EVALUATION OF CLINICAL SKILLS
Hippo Virtual Proctoring™
Essential clinical skills and capabilities are being evaluated and assessed in real time using Hippo Virtual Proctoring, which ensures quality and safety. This practical assessment and teaching function is critical for developing new skills and for refreshing those skills which are used infrequently.

CLINICAL GUIDANCE FOR FIRST RESPONDERS
Hippo for First Responders™
Clinicians in an ambulance or mobile unit are receiving “as needed” clinical guidance from a physician in the emergency room enabling more rapid and accurate diagnosis and treatment in the field.

Key benefits

INCREASED EFFICIENCY + PRODUCTIVITY
Location independence is delivering significant time and cost savings due to decreased travel time, a reduction in appointment delays/cancellations and decreased risk of contracting or spreading communicable diseases.

SUPERIOR EXPERIENCE
A superior remote learning experience is providing a “through the eyes of the clinician” viewpoint and immediate clinical feedback.

REAL-TIME DEMONSTRATION OF COMPETENCY
Students are demonstrating competency in skills and procedures, and receiving real-time guidance and feedback from clinical experts.

HANDS-FREE, VOICE-ACTIVATED OPERATION
Hands-free, voice-activated, lightweight device allows faculty to lecture remotely to one or more students. Students are receiving discrete instructions and guidance from proctors to enhance performance through internal speakers.

CONTINUOUS COMMUNICATION
Continuous communication is enabling faculty to receive and respond to students’ questions in real time through internal loudspeakers and digital microphones with noise cancellation.

CONVENIENT VISUALIZATIONS
Clinicians are able to view patient medical records or evidence-based guidelines on micro-display without turning away from the patient and without visual field constraint.

AVOID CROWDED ROOMS
Avoiding crowded patient rooms is helping to deliver a superior patient and provider experience and increased safety.

SPECIALITY SERVICES IN VARIOUS SETTINGS
Hippo Virtual Care is enabling the delivery of specialty services in a variety of diverse settings – in the community or in the home.

Technology becomes transformational if it’s used to solve problems. We must leverage Virtual Care platforms such as Hippo to democratize access to good quality healthcare around the world.

Wale Sulaiman, MD, PHD, FRCS(C) // CEO, RNZ Global

RNZ Global is a Healthcare Service Provider. Their services include establishment of Centres of Excellence for the care of patients with neurosurgical diseases (RNZ Neurosciences); Hospital Development, Operations and Management; Healthcare Innovation — Digital and Virtual Care; Health Education and Training; Distributorship of Innovative Healthcare Products; and Healthcare Manufacturing. They are at the forefront of revolutionizing healthcare in sub-Saharan Africa through using emerging and established technological advancements in medicine.

Hippo Tech Device Gives Podiatry Students a Live Clinical Experience in the Classroom

Closing the Gap

Barry University’s School of Podiatric Medicine has added an exciting innovative technological tool to its instruction toolbox to implement remote patient care learning.

The school is now using the Hippo virtual care device in our “Intro to Patient Care course in the Freshman Year”. Hippo is voice-activated, hands-free, and resembles goggles. It brings streaming doctor-patient visits from clinics to the classroom for a real-time clinical experience. 

It allows healthcare providers and educators to bridge the gap between physical and virtual care. Due to the limitations of meeting in-person during the COVID-19 pandemic, remote healthcare and learning became an essential part of growing and connecting as students and medical professionals. 

“The practice of medicine is ever-changing. Here at Barry University School of Podiatric Medicine, we are up to date with the latest technology to address this new world’s challenges.” Professor Dr. Rodriguez-Anaya explains. Due to limitations of meeting face-to-face, Barry recruited doctors to create educational videos. With the device, students can see patients in real-time as if they were in the clinic. The doctor can be heard through the device and the student can ask questions. Hippo offers students a physician’s point-of-view.

“Hippo technology allows us to continue our clinical education experience and expand into areas that we were not allowed before,” she says.

“The Hippo technology will enable us to stream doctor-patient visits to our classrooms, for real-time clinical experience for our first-year students. Beyond further elevating the cutting-edge educational experience for our students, we anticipate utilizing Hippo on medical mission trips, connecting underserved communities with our world-class providers.”

Dr. Robert Snyder, Barry University Podiatric School of Medicine

There are many additional perks to using Hippo that may not be immediately apparent, including community-building. Azariya McClendon, class of 2024, believes “Hippo will also help students early in their medical school career build long-lasting professional relationships with surrounding physicians.”

Shane Massey, also class of 2024, observes that the tool deepens opportunities for understanding curriculum. “Applying our learning to real life situations makes our educational experience less about simply passing classes and more about learning the skills and techniques necessary to becoming great physicians.” Alexis Mugno, who is a second year resident in the field at Jackson North, says these real world experiences will enrich “young student-doctor’s education and bedside manner.”

Patients need not worry, either. Hippo is HIPPA compliant and safe for users and patients. It’s linked to a secure stream that is password-protected and securely tied to one user.

Sheena Cherukara, who will graduate in 2024, says of the device, “I have a great feeling that this will heighten the field of podiatric medicine in the long run for many of us students, professors, and health care professionals.”

Barry University is a university founded in 1940 in Miami Shores, Florida. The university offers more than 100 degree programs in six schools and two colleges, including the Barry University School of Podiatric Medicine, one of only nine podiatric medical schools in the United States.

Hippo Virtual Care Making A Difference to Wound Care at Michigan Medicine

At Hippo, we’re always looking to highlight innovative people in the healthcare community. We recently sat down with Dr. Alton R. Johnson, Jr. to talk about his role as a current Fellowship Innovator in the 2023 “Research | Innovation | Scholarship | Education” (RISE) program at the University of Michigan and to discuss how Hippo Virtual Care has helped Dr. Johnson achieve his goals for the program.

 

Meet Dr. Johnson

Dr. Johnson, DPM, FACPM, FASPS, CWSP, is a Clinical Assistant Professor, Podiatrist, Podiatric Surgeon, and Wound Care Specialist at the University of Michigan Medical School in Ann Arbor, Mich. He is one of 10 current 2023 RISE Fellowship Innovators. He loves a lot of things about his job, but there’s one thing in particular that brings him great satisfaction: “There is nothing more gratifying than healing a patient that has a chronic wound. The physical, psychological, and financial burden that comes with caring for a chronic wound cannot be qualified, so my goal is to heal these wounds as soon as possible.”

 

What is RISE?

The purpose of RISE is to innovate education for better health. Per their website: “RISE aspires to create a Michigan Medicine culture where bold, scalable education innovations impact health and science, and thrive through collaboration and access to a broad, diverse network of resources, expertise, and stakeholders.”

The RISE program, Dr. Johnson explained, is exclusive to Michigan Medicine. They guide the selected innovators for the 12-month calendar year to develop and implement a health science education idea that will impact science, health, and/or healthcare. “Throughout the year, we meet monthly to learn and implement innovation strategies, translational education, and pedagogical principles,” he shared.

 

Dr. Johnson’s involvement in RISE

After applying and interviewing for the RISE program in the fall of 2022, Dr. Johnson was accepted into the third RISE cohort in January 2023. The proposed project, he explained, is creating “workflows” for podiatric and wound care-related pathologies, procedures, and surgeries to aid with active learning of medical students and residents. “Once I have developed templates oriented for podiatric medicine and wound care, the goal is to execute the ‘workflows’ using augmented reality (AR) during medical education and clinical experiences.”

The project’s secondary goal is to aid with the enhancement of educational experiences of visiting nurses that use real-time evaluation, management, and assessment of homebound wound care patients.

Hippo’s role in RISE

Throughout 2023, Dr. Johnson will utilize the Hippo Virtual Care voice-activated headset and platform to develop and execute his novel innovation ideas. “I am in the piloting stages and will be publishing the findings soon,” he said. “The feedback from users and patients has been overwhelmingly positive so far, mainly in the areas of accuracy, focused evaluation, and patient assessment.”

Dr. Johnson said that Hippo’s device and proprietary software has boosted the confidence of the residents and fellows that utilize it for patient workups, which has translated to more meaningful patient care experiences.

We asked Dr. Johnson to share what he liked best about Hippo Virtual Care, and he responded, “My favorite thing is that it’s HIPAA-compliant, which puts both providers and nursing staff at ease when it comes to protecting patient-sensitive information.”

 

Future uses for Hippo Virtual Care

Dr. Johnson sees many opportunities to use Hippo Virtual Care in the future. “With the current and impending physician shortages, Hippo Virtual Care could be a valuable solution for any health system. As time goes on, it will be more of a challenge to get face-to-face care from a specialty physician like myself. Utilizing safe and effective technology platforms like Hippo Virtual Care will likely be the solution for the foreseeable future.”

About Dr. Alton R. Johnson Jr., DPM, FACPM, FASPS, CWSP

Dr. Johnson is a Clinical Assistant Professor, Podiatrist, Podiatric Surgeon, and Wound Care Specialist at the University of Michigan Medical School in Ann Arbor, MI. He is one of 10 current RISE Fellowship Innovators, and has been the recipient of several awards including the 2022 American Podiatric Medical Association President’s Award, the 2022 Kent State University College of Podiatric Medicine Young Physician Professional Achievement Award, and the 2022 Association for the Advancement of Wound Care Emerging Leader Award.