CRAIG T. KOJIMA / CKOJIMA@STARBULLETIN.COM Patient Ruth Forrey, 100, talks with Dr. Dan Davis on a video system he invented. Her caregiver is Barbara Bascom.

Video system lets doctor make virtual house calls

A Honolulu doctor’s company fills gaps, from daily monitoring to time saved in crises

A doctor diagnosing Ruth Forrey via video on a computer screen might have saved her life in March, caregiver Barbara Bascom says.

"She had a little ministroke. ... I knew something was wrong," said Bascom, explaining that she immediately called Dr. Daniel Davis Jr. and turned on the computer camera.

"He answered the phone and logged on to the computer. He had a visual within two minutes of the incident."

Bascom said Davis called the hospital and told them what would be needed for Forrey while she called 911. "I think that's why she did so well, with little residual problems," Bascom said. "All of it was incredibly fast. It was just wonderful, having the ability to reach him through the camera. There's an immediate response. It was just awesome."

Davis, who practices internal medicine in the Queen's Physicians Office Building I, also is chief executive officer of Interactive Care Technologies.

He said he and his brother, Dr. Duane Davis, a business computer expert in Georgia, started the company several years ago as Adaptive Learning. They created a device to help children with attention deficit disorder stay on task.

He said he "got the idea this would probably be helpful with people with medical regimens" and rewrote the software to take advantage of the Web.

He and his brother sold the company, then bought it back a few years later and registered it as a Hawaii company last spring "to take advantage of some of the high-tech environment here."

"Our goal is to develop technologies and modes of delivery of health care that are a lot more convenient and a lot more effective, because you can sort of reach out and touch them (patients) a lot more frequently than you could otherwise," Daniel Davis said in an interview.

"The fundamental technology is a virtual care team, mostly Web-based."

Bascom said she was excited when Davis told her about the system about two years ago. "We were so pleased we were able to get in on this cutting edge. ... It is awesome."

She has not had to take Forrey to the doctor's office for monitoring since getting the video system, she said. This has been particularly helpful since July, because of difficulty getting Forrey in and out of a car, she said.

"There are just so many instances of how this has helped us. It is just incredible. We have some scheduled appointments (with Davis on camera), and we have the freedom of calling any time for any questions."

Davis made a house call via video to Forrey shortly after her 100th-birthday party Dec. 11. Bascom positioned the camera facing the patient, and Davis controlled the picture remotely from his office.

He asked Forrey, "How does it feel to be 100 years old?"

"It feels like 100 years old," she quipped.

Davis carefully examined Forrey with Bascom's help, looking at her veins and skin spots and asking her to lift her arms and do a few other tests.

Bascom earlier had taken Forrey's blood pressure, 108 over 77, and pulse rate, 82, and the data automatically went to the doctor's computer.

She can listen to Forrey's lungs and heart with a stethoscope, and if a blood sample is needed, she can take her to Diagnostic Laboratory nearby or call nurses to the apartment.

Davis noted a little weakness on the left side of Forrey's face, made some medical suggestions to Bascom and scheduled another video call. "I think she's doing wonderfully well," he said. "Give her a big hug for me."

Cory Lee, owner and nurse administrator of Healthcare Alternatives, said the agency's nurses assist Davis with televideo assessments at a patient's home and show families and caregivers what to do.

"It's not a very big system right now, but it has proven to be wonderful with patients who have significant wounds ... and patients with congestive heart failure who need daily monitoring," she said.

Vital sign monitoring, done automatically with a little box and blood pressure cuff attached, is another option, he said. Information is sent to the doctor over a regular telephone line or by computer.

Davis said he has six patients on video now and 30 on the telemonitoring box. He has probably had 20 to 30 patients on video calls and 100 to 150 with some kind of vital sign monitoring since beginning the service, he said.

The telemonitoring box is particularly useful in managing someone with heart failure or diabetes, he said.

An interactive voice system also will call people and ask what the blood pressure is, and a computer will analyze the information and put it into the database.

The database looks at the information and matches blood pressure, blood sugar or weight to a particular patient's pattern, he said. If the pattern is erratic, the system will alert the caregiver.

The basic video equipment costs about $1,500 to purchase plus about $150 a month, he said.

The box to monitor vital signs is the least expensive, costing from $35 for a basic personal emergency response system up to $100 or more depending on services desired.

Insurance does not cover the costs, but Davis believes it will eventually "because the arguments for it are so compelling.

"I think we can probably reduce hospital days by 50 percent for these people. ... Many see it as an alternative to a nursing home. If you avoid one year in a nursing home for a family member, you save a lot of money."

Video doctor on call patient’s ‘idea of heaven’

Quick action keeps the lung patient from suffering a potentially debilitating cold

Irma Cunha, 82, who has chronic obstructive pulmonary disease, saw her doctor three times in the past three months without leaving home.

"I needed him to listen to my lungs, and to be able to sit in my own house and have him listen to my lungs is my idea of heaven," said Cunha, vice president of the residents' council at Kahala Nui.

She called Dr. Daniel Davis Jr., her doctor since 1989, and he made video house calls to her apartment in the assisted-living facility.

"There's nothing to it," said Cunha, who got the video system three months ago. "All you have to do is push a button. He does all the work, and I have my phone on 'speaker' so I can listen to him."

She pushes the button to turn on a camera mounted on a tripod in front of her. "I just sit there and he moves the machine. If he wants me to use the stethoscope, I do. He tells me where to put it -- move it up, move it down.

"The thing can point all the way down to my feet to see if my ankles are swollen."

Cunha said her disease, "probably from years of smoking," is a combination of asthma, bronchitis and emphysema. "As time has gone on, I have more episodes. If I catch cold from someone, I'm doomed.

"Instead of going down to see Dan when this happens, this wonderful machine does it all," said Cunha, who also serves on the board of the Outdoor Circle and supports the Nature Conservancy and the Hawaiian Humane Society.

The three times she called him, she thought she might be getting a cold. "If we catch it early, I can go on heavy steroids and lessen its effects."

One of those times was on a weekend, when he was at home, but he responded instantly, she said.