|Old-fashioned Compassion Meets Modern-Day Know-How. Dr. C. Anne Patterson is seen here, in her Sandy Springs-based medical offices, reviewing a sonogram before beginning a live video consultation with that same patient. The AE alumna has served thousands of mostly low-income women using telemedicine technology to connect patients with care.
|Dr. C. Anne Patterson, AE '71, '75
CEO of Women's Telehealth
Telemedicine – the delivery of healthcare via telecommunication technologies – has been around for decades. But it took an AE alumna to get it just right.
“We were doing telemedicine at NASA in the early 70’s, but it was awful medicine by current standards,“ says C. Anne Patterson, AE '71, '75, a former NASA propulsion engineer who worked on early telemedicine technology.
“What we did was provide a satellite to provide information about birth control that people in India could watch in between regular television programing. Later, the satellite was re-purposed to send medical information to physicians in very remote areas of the Rocky Mountains. That was the extent of our ‘telemedicine’ in the 70s."
Fast-forward four decades. The telemedicine practiced by Dr. C. Anne Patterson - now a board certified OBGYN and CEO of Women's Telehealth - is nothing like the medically-themed infomercial that was beamed down from a satellite in the 70's.
It's a systematic use of several technologies (including satellites), all with the goal of delivering personalized medical care directly to patients in remote areas. Telemedicine is also removing one of the largest barriers to health care delivery in the rural South: a chronic shortage of specialized medical practitioners.
Instead of traveling to Patterson’s metro Atlanta-based office for maternal-fetal healthcare, patients visit a clinic near their home where their consultation with Patterson is conducted via video conferencing on a secure HIPPA-compliant network. Specially engineered medical equipment and cloud-based data exchanges allow Patterson to collect and analyze important data on each client before the session begins. A blue tooth-enabled stethoscope even allows her track fetal heartbeats hundreds of miles away.
“We’ve been able to set up clinics in seven southern states. We’ve reached more than 30,000 mostly low-income women – women who would not have access to maternal fetal health,” she says of her flourishing practice. “This is what telemedicine is capable of doing.”
Inside a Telemedicine Consult
With the patient’s full permission, we sat in on Patterson’s video consult with “Susan” (not her real name), a 23-year-old who is 25 weeks pregnant with her first child. The camera pans on a young woman who is staring awkwardly at the floor.
Like all Telehealth patients, Susan is accompanied by a medical professional—someone on her end who can answer follow-up questions after the visit – but the next half-hour will be a one-on-one between doctor and patient. Susan’s chart tells us that she has bi-polar disorder, a seizure disorder, a meth addiction, and attention deficit disorder. She was only recently released from a rural jail, where she was serving time for a minor drug offense.
Patterson starts on an up note.
“Well I’m looking at all of your pictures [sonograms] and I can tell you so far, so good. All of the anatomy we see looks really good. With some of your meds, there would be a concern about a cleft lip or palette, and I can tell you that all looked normal. Baby weighs one pound, 14 ounces and that’s good.”
Susan picks up on Patterson’s obvious concern and begins looking directly into the camera. The questions cover some tender territory – drug use, mental health, legal issues - but there is clearly something about Patterson’s tone – direct, but warm – that relaxes her. Patterson weaves in suggestions for finding a drug-free environment when Susan is able to live on her own, and for avoiding acquaintances who do drugs. She ends the consult by prescribing a pregnancy belt to address physical discomfort and a referral to a social worker who is both appropriate and accessible to the young woman.
“You have a beautiful life ahead of you, with that beautiful baby,” she says. “Let’s talk about this again in a month.”
With that, the video disappears and Patterson turns to another screen to document the visit. There’s a lot to write, but, after a few minutes, Patterson pulls herself away to tell her visitors what’s really on her mind:
“Every time I see a patient like Susan, I feel like God sent me here for a purpose," she says.
"And my purpose is to see that women who are often poor, maybe hardly have gas money to drive across the county, or may even be incarcerated – all get the kind of medical help that they might not otherwise get. Maternal fetal medicine is about healthy beginnings. I can’t think of a more important connection to make.”
Patterson will readily tell you that the two aerospace engineering degrees she earned at Georgia Tech ultimately helped her to build Women’s Telehealth. The engineer inside this physician was always looking for things to optimize.
“As a trained engineer, I was used to looking at a system to see if it could work better and that perspective helped our practice. We’ve gotten the cost of outfitting [clinics] down to around $10,000 which has really helped us grow. And there’s always room for us to improve our use of the technology. I’m not a person that can write computer code, but I knew we could improve things if I found the right person. So I tracked down a developer out of Boston who was able to create a form of an HL-7 interface that’s allowing us to get ultrasound data and reports through a cloud-based system.”
The physician inside this engineer didn’t emerge until after Patterson had completed a master’s degree in aerospace engineering. Med school and residency were her second act.
“Over the years, people have asked me, ‘how did you get into this sort of work?’ And I always give them the 30-second story about how, when I was at NASA, I got called to work on a biomedical project at Johns Hopkins, and that that project introduced me to the person who developed the first laser ever used in surgery. He wanted me to go to med school so that there would be a medical doctor who fully understood how to use his instrument. Well I finally listened to him. I went to med school. But the truth is, it's more personal. Because I don't think there's any question that God called me to do this.”
Patterson chose her medical specialty – maternal fetal medicine – in part because it plays such a critical role in Georgia, which has some of the highest rates in the United States for maternal mortality and pre-term delivery, particularly among women of color.
She may never meet any of her patients in person, but, through Telehealth, she can consult with them in a trusted, community setting. Anecdotally and statistically, the results are promising.
“We conducted a study in Albany Georgia – an area that had preterm birth rates of 18 percent for African American women, and 16 percent for Hispanic women. Those rates were the highest in the state, which, again, are higher [11.4%] than the national average [9.93%]. While it was a tough area to choose, everyone was receptive to trying something new to make a difference. We found after bringing telemedicine into the area for 18 months and partnering with the providers there, there was a significant difference – for African American and for Hispanic women. Pre-term birth rates dropped to 8 percent and 6 percent, respectively. That’s lower than the national average. And the rates remain at this level or lower.”
Telemedicine is uniquely suited to address the problems faced by the rural poor. It does not involve high transportation costs, travel time, childcare, or Medicaid barriers. With all of these barriers eliminated, patients are more likely to initiate and maintain contact with the medical system earlier in their pregnancies.
Women’s Telehealth zeros in on helping these high-risk patients to manage chronic health problems – like diabetes and hypertension– that could threaten their pregnancies. In a typical consultation, the conversation rarely ends when doctor and patient have checked off all the obvious medical issues, however. Before the video shuts down, Patterson leans into almost motherly advice for her patients, who are likewise drawn into something surprisingly intimate.
“With a lot of my patients, you have to take a step back and see where they are,” Patterson observed. “All the high-tech in the world isn’t going to cure having no place to live, not enough food to eat, or not enough money for medication. There are social programs in place that can help but the patients have to be connected with them. You have to bring those things up or you’ve failed them.”