Posters IV - The American Academy of Clinical Toxicology

submission. While this is below the expected volume of reportable cases, it illustrates the potential of
poison centers to contribute to medication safety reporting. Conclusions: Limitations include the need for
staff re-education and the time required of clinical staff to review cases. Case submission is not a factor,
as this is accomplished electronically by a poison information provider. To address these deficiencies,
pharmacy students completing their experiential rotation in toxicology / drug information are now being
utilized to review cases and will reduce the time burden on clinical staff. Additionally, brief re-education
sessions at several monthly staff meetings throughout the year will improve the overall number and
appropriateness of cases flagged for Medwatch® by SPIs.
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Use of Robotic Telepresence for Poison Center Based Medical Toxicology Consultations: TeleToxTM
A C Bronstein 1 , P Huang 2 , S Banerji 1 , A Gilbreath 2 , T Whitmore 2
1 Rocky Mountain Poison & Drug Center-Denver Health, Denver CO USA
2 Saint Alphonsus Regional Medical Center, Boise ID USA
Background: Regional Poison Centers (PCs) routinely provide hospital and telephonic medical
toxicology consultation. Although telephonic consults are limited to voice, hospitals can fax/email test
results, and substance/clinical pictures on request. However, this process does not match bedside
consultation. To improve on this provision of care, we piloted toxicology consultation via remote presence
robots at a metropolitan and rural hospital system: TeleTox TM . Methods: We partnered with an 8 hospital
telehealth network (metropolitan hub and 7 rural hospitals; bed range 10 - 361) serving one state using
either RP-7 or RP-Lite telepresence robots (InTouch Health, Santa Barbara, CA) to converse with hospital
emergency departments and critical care units. Training with the robots was conducted for all participating
medical toxicology fellows and attendings. RP-7 Robots with 30 frame/second video for real-time motion
capture can sense obstacles and move under manual video control to safely gain clear patient access. An
initial robot laptop base station was replaced with a hardwired, encrypted desktop and T1 line in the PC.
Consultations were initiated by the patient's hospital by contacting the hub-hospital's Access Center,
which then contacted the toxicologist using the PC 800-number. Special patient consent was not required
as no video recording was made. Initially Access Center personnel drove the robots as directed by the
consulting toxicologist, and were available to coordinate transport if necessary. Headphones were
available for both the toxicologist and SPI. Consult notes were entered into the PC case management
system. The treating health care provider remained in charge of the patient's care with the toxicologist
making recommendations as usual. Initially, TeleTox TM consults were available 9 am - 5 pm Monday –
Friday. Results: A series of 2 mock cases was conducted with each toxicologist and ED staff from
participating hospitals. Toxicologists also "beamed" in to 8 staff meetings to meet the remote ED
physicians and staff. TeleTox TM went live on 14 February 2011. A total of 2 consultations have been done.
TeleTox TM consult length appears longer than similar telephone consultations. Data continues to be
accumulated. All TeleTox TM patients survived. Conclusions: Robotic toxicology telepresence
(TeleTox TM ) is a promising PC application. Teletox TM has been well accepted by PC staff, physicians, and
patients. Expansion to SPI follow-up calls and extended consultation hours with individual laptop systems
outside the PC is possible. TeleTox TM may also have applicability for cross-town PC consultation with
multiple hospitals or during public health events.
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