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House calls go digital for spine treatment

By University of Utah Health Care | Posted - Dec 13th, 2016 @ 3:03pm



Floyd Whybark had been experiencing back pain for years, but neglected going to the doctor. “My kids had been after me to have it corrected,” he said, “but I was afraid. I told them I wouldn’t have an operation until I couldn’t walk anymore, and that’s what happened to me last summer.”

Whybark also faced a geographic challenge. He and his wife Violet split their time between two small towns – one in California, one in Washington – neither with substantial medical facilities. Luckily, their daughter Teresa began investigating options and came across the University of Utah’s Spine Second Opinion Program. By filling out a questionnaire and uploading some images, Whybark could quickly get in touch with U doctors some 750 miles away.

“There wasn’t a full workup of his spine condition,” said Brandon Lawrence, MD, a University of Utah Health Care orthopaedic spine surgeon who reviewed Whybark’s file. To understand what was really happening, he ordered more scans from Whybark’s primary-care physician. “We were able to do that from afar, have them uploaded, and then I was able to look at it and say, ‘This is what I think you need, but come here and we’ll talk.’”

The Whybarks set up an appointment on their way to California for the winter. After just four days, Dr. Lawrence diagnosed Whybark with compressed nerves, performed a successful decompression, and sent his patient off to California.

Rural options

Roughly 20 percent of Americans live in rural areas, but just 9 percent of physicians practice there. When even primary care options are slim, seeing a specialist becomes a time-consuming and expensive endeavor that usually involves travel and boarding in the nearest big city, all without the guarantee a patient’s problems will be solved.

To expand their reach, many physicians are turning to remote consultations. At University of Utah Health Care, Dr. Lawrence and the Spine Services team developed the Spine Second Opinion Program specifically for those who can’t make a quick trip to Salt Lake City. Patients can create an account, fill out a short survey, and upload images to give doctors a running start on a diagnosis.

“They can easily get either an initial opinion based on uploaded images and some descriptions of their ailments, or a second opinion on a spine procedure that was given by another provider,” Dr. Lawrence said.

It’s a service of tremendous value to rural patients. If their back trouble is nothing serious, the online consultations can save patients a costly trip to the city. But in instances where further treatment is needed, patients and doctors can begin discussing possible treatment methods before an appointment is even scheduled. This means the actual examinations and operations take place in a far more efficient manner.

“Hopefully it will help eliminate unnecessary travel, and make it easier for patients and their families,” Dr. Lawrence said. “That was the main impetus behind this tool.”

Easy logistics

The University of Utah Health Care Spine Services was Whybark’s first stop for care, and he found the combination of remote consultation and streamlined in-person care refreshing. “It was great,” he said. “I’m more than happy with the doctors there, and the hospital was wonderful.”

Dr. Lawrence had to decompress the nerves at multiple levels along Whybark’s spine, so it has been slow going for the 84-year-old. But Whybark’s mobility is improving, and it’s far better than it was at the beginning of the summer.

Whybark’s check-up will be a simple process, too: He and Violet will stop in Salt Lake City during their migration north in April. This time around, the following road trip should be easier on Whybark.

“Four days after my operation, I rolled in the car and drove 850 miles in two days,” he said. ”I’m very happy with the results - I seem to be so much better than I was.”

That outcome is what Dr. Lawrence and the Spine Services team envisioned when they designed the Spine Second Opinion Program. For some patients, more efficient care will be the primary benefit. But for others like Whybark, Dr. Lawrence’s program opens treatment options that previously weren’t available at all.

University of Utah Health Care

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