Rodett Osorio, PA-C

Rodett Osorio knows what it’s like to make quick decisions as an emergency medicine PA at Culberson Hospital, a tiny critical access hospital in rural Van Horn,Texas.

When an elderly patient arrived at his hospital complaining of weakness in one side of her body, he was immediately able to recognize her stroke-like symptoms and order a CT scan of her brain, but he knew he’d need the advantage of another clinician’s expertise.

From the patient’s room, Osorio was able to push a button to connect with a neurologist in Colorado who could evaluate the patient’s condition.

The neurologist appeared in a matter of minutes to assess the patient through a sophisticated monitor and camera system with a fish eye lens that allows an operator to zoom in close enough to see a clear image of the patient’s pupil. The neurologist was able to decide whether the patient was a candidate for Tissue Plasminogen Activator (tPA), a medication that dissolves blood clots, and is commonly referred to as the “clot buster.”  If given within the first 3-4 hours following the onset of stroke symptoms, a patient who receives tPA will have a higher chance of improving from their stroke symptoms.

“With stroke patients, if you don’t treat them right away they have a higher chance of permanent disability,” he said. “Connecting the patient to quick care was instrumental in preventing permanent disability.”

When the patient was readmitted to the hospital for rehabilitation, she had no neurological deficits because the team was able to diagnose, treat and transfer her to a higher level of care in a timely manner.

Osorio sees a variety of patient problems in the emergency room and often relies on telehealth to connect patients with more severe cases to experts and specialists located in South Dakota,Colorado and El Paso. He’s part of a small cadre of one doctor, one NP and two PAs who rotate on 24-hour shifts, 8 to 10 days per month. Telehealth substantially improves the team’s ability to sustain operations and provide quality care amid staffing shortages.

“The number one problem in rural areas is coverage,” he said. “Our physician is stretched thin. Our telehealth systems allow me to work in the ER without having a physical doctor available.”

While the hospital lies in a sleepy west Texas community, it’s the only acute care hospital within a four-county area. It may appear like an ordinary rural hospital, but it’s distinctively drawing attention from other rural hospitals in Texas as the lone facility to implement a telemedicine program.

“All eyes are on our hospital,” said Osorio. “We are the first hospital in Texas to be granted a waiver by the Texas Department of State Health Services. The waiver allows the use of telemedicine and PAs and/or NPs in lieu of round-the-clock ER physician coverage as required for Level IV trauma designation.”

The waiver has allowed the hospital to test the applicability, scalability and effectiveness of telemedicine to deliver the same standards of care to patients. All cases that use telemedicine are sent to Texas A&M Rural and Community Health Institute for peer review. 

“We track and trend all cases to see any opportunities for improvement,” he said. “Because of telemedicine, we are able to more quickly diagnose patients, connect them to specialized treatment, and if necessary, transfer them quickly to higher levels of care.”

That’s a triumph for hospital staff, but even better news for patients, who don’t have to travel two hours to see a specialist in the next nearest town of El Paso.

“We can provide lifesaving consultations on-site without patients having to endure long commutes,” he said. “Sometimes, it’s the only way they’ll receive specialized care at all.”

For stroke, cardiac, sepsis and trauma patients, telemedicine has been a lifesaver. It’s given patients access to convenient health care services without compromising the quality of care, and providers a lifeline to experts in specialized areas of medicine.

“There are months when we use it sparingly and months when we rely on it several times a day,” he said. “It’s been a great opportunity for me to work alongside specialized physicians through telemedicine and have the support that I can count on when needed, and when it matters the most.”