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Mayo robot to flag gridiron concussions

Mayo study first to explore whether remote neurological assessment is as accurate as a face-to-face evaluation
By Bernie Monegain

Mayo Clinic will be working with Northern Arizona University to test the feasibility of using a telemedicine robot to assess athletes with suspected concussions during football games.

With sophisticated robotic technology, use of a specialized remote controlled camera system allows patients to be "seen" by the neurology specialist, miles away, in real time. During the study, the robot equipped with a specialized camera system, will be remotely operated by a Mayo Clinic neurologist located in Phoenix who has the ability to assess a player for symptoms and signs of a concussion and to consult with sideline medical personnel.

The initiative is part of new research undertaken by Mayo Clinic.

"Athletes at professional and collegiate levels have lobbied for access to neurologic expertise on the sideline,” Bert Vargas, MD a neurologist at Mayo Clinic who is heading up the research, said in a news release. “As we seek new and innovative ways to provide the highest level of concussion care and expertise, we hope that teleconcussion can meet this need and give athletes at all levels immediate access to concussion experts."

[See also: Telehealth reaches the American frontier.]

The Mayo study is the first to explore whether a remote neurological assessment is as accurate as a face-to-face evaluation in identifying concussion symptoms and making return-to-play decisions. Mayo Clinic physicians will not provide medical consultations during the study; they will only assess the feasibility of using the technology. If it appears feasible, this may open the door for countless schools, athletic teams, and organizations without access to specialized care to use similar portable technology for sideline assessments.

"As nearly 60 percent of U.S. high schools do not have access to an athletic trainer, youth athletes, who are more susceptible to concussion and its after-effects, have the fewest safeguards in place to identify possible concussion signs and symptoms at the time of injury," Vargas says. "Teleconcussion is one way to bridge this gap regardless of when or where they may be playing."

Others involved in collegiate sports agree.

"At NAU, our primary goal is to provide an outstanding student-athlete experience culminating in graduation," Lisa Campos, vice president for Intercollegiate Athletics at Northern Arizona University, said in a statement. "We charge our staff to research the most current and best practices to ensure the safety and care of our students. Partnering with the Mayo Clinic in its telemedicine study will further this research and potentially improve diagnosis for rural areas that may not have access to team doctors or neurologists. The study allows the NAU Sports Medicine Staff and team doctors to continue to make all diagnoses and return- to-play decisions for our students, while investigating the effectiveness and efficiencies of telemedicine. We are excited to have the teleconcussion robot on our sideline this fall."

[See also: North Carolina bullish on telepsychiatry.]

"There were a number of examples last football season where college football players clearly demonstrating concussion-like symptoms were quickly thrown back in games or weren't even taken out of the game for an evaluation," Ramogi Huma, executive director of the National College Players Association, said in the news release. "College football players are in desperate need for independent concussion experts on the sidelines, and this study could help make that safeguard a reality."

Mayo Clinic in Arizona first used telemedicine technology with the telestroke program in 2007, when statistics revealed that 40 percent of residents in Arizona did not live in an area with stroke expertise. Mayo Clinic also bills itself as the first medical center in Arizona to do clinical research to study telemedicine as a means of serving patients with stroke in non-urban settings, and today serves as the "hub" in a network of 12 "spoke" centers, all but one in Arizona. Since the telestroke program began nearly 3,000 emergency consultations for neurological emergencies between Mayo neurologists and physicians at the spoke centers have taken place.

In 2011, Mayo Clinic expanded its telemedicine evaluations to include concussion evaluations. Concussion experts at the Mayo Clinic Comprehensive Concussion Program in Arizona coined the term "teleconcussion" and described the concept as an effective means to assess concussed patients in a case study published in the December 2012 issue of Telemedicine and e-Health.