Being the official hospital of an NFL team has its perks. A two-year pilot project using telemedicine to treat concussions will soon begin at Houston Methodist Hospital, delivered through funding from a collaboration with the Houston Texans and GE Healthcare.
The project will take place at the hospital’s Concussion Center, and will make telemedicine available to student athletes at 19 rural school districts. Equipped with a Microsoft Surface, an athletic trainer will be available to go to a game or practice when a student athlete is pulled for a possible concussion. There, they will use the imPact neurocognitive assessment app and a Skype call with a Houston Methodist Concussion Center physician to perform a comprehensive concussion evaluation.
The program will impact about 50 students. If it is successful, the goal is to expand it statewide. While diagnosis and treatment of sports-related concussions in Texas has improved since the 2011 passage of Natasha’s Law (wherein coaches and athletic trainers were required to receive training on how to respond to concussions), that still isn’t enough, said neuropsychologist and director of the Concussion Center Dr. Kenneth Podell.
“The coaches are doing their part, but a lot of these schools don't even have athletic trainers, specially those in rural areas, so all these kids still aren't getting comprehensive care to treat concussion,” Podell told MobiHealthNews in an interview.
If the pilot proves successful, it could eventually lead to a statewide program to give all athletes in Texas access via telemedicine to concussion care experts at the Houston Methodist Concussion Center. Part of making it successful is working out the logistical problems, intrinsic challenges and bugs that are occuring right now. For example, many athletic centers, where the examinations must be performed, are in what Podell described as "the bowels of the school," where connectivity is poor.
"A big part of this is enlightening me and what I need to do to make this successful, because there are a lot of things that we don't realize until we get out there and try to make this work," Podell said.
There is a growing field of digital tools to detect concussions, as well as increasing focus on the assessment and treatment (or lack thereof) of student athlete concussions. In 2014, the NFL and GE came together to form the $20 Million Head Health Challenge, (which this project is not under) and we’ve seen a number of tools emerge that all have the goal off curbing the high rates of concussions in athletes, especially students who do not have access to doctors on the field. Every year, 20 percent of high school athletes sustain a concussion, and 39 percent of them continue to play after a head injury. Houston-based concussion management system BrainCheck raised $3 million to expand its mobile neurocognitive assessment app, and software company ImPact was granted de novo FDA clearance for concussion assessment apps.
“Replacing an office visit with a telemedicine visit can allow the student athlete begin the correct treatment plan sooner and safely return to school and sports faster,” Houston Texans VP of Corporate Development Greg Grissom said in a statement. “Many student athletes in southeast Texas are two to three hours from a concussion specialists, so this telemedicine program gives Houston Methodists a chance to provide the same level of concussion care as our players receive.”
Podell, his fellow Concussion Center physician Dr. Vijay Jotwani and three athletic trainers will be doing the bulk of the work for now, and they will add more people program is adopted statewide after two years. What is immediately needed, however, is to expand education. In rural areas, not everyone has the same level of knowledge and wariness around concussions, and thus may not be apt to seek treatment, Podell said.
"Once you get out of the city, you see that what people understand about concussions is quite different," said Podell, who is also working on creating a training video to expand concussion education. "And it's both ways – you have to start understanding how important football is to the culture in these areas, it really starts to shift a little bit. So it's taken some time to shift my mindset, too."