Case study: NYS SAFE Telemedicine Pilot Program with St. Peter’s Health Partners and United Concierge Medicine
In the United States, one in five women and one in 71 men will become victims of sexual assault during their lifetime. The physical and mental health needs of sexual assault survivors are many, but for those who come forward with their stories of assault, it is of the utmost importance they have access to a Sexual Assault Forensic Exam (SAFE) to document any injuries or DNA evidence present. However, the US is facing a severe shortage of qualified Sexual Assault Nurse Examiners (SANE) needed to perform such exams. With limited state budgets, innovative new methods are needed to ensure survivors get the standard of care they deserve.
A number of communities around New York State lack the necessary forensic services for sexual assault survivors to be properly examined, especially in rural or smaller communities. Many hospitals in such areas lack the resources needed to employ a full-time SANE team or instances of sexual assault are not reported frequently enough to warrant a full-time SANE team.
There is a need to provide sustainable, cost-effective SANE coverage for these underserved communities. To meet this goal, the New York State Office of Victim Services (OVS) and Department of Health (DOH) provided a three-year grant to leverage the power of telehealth to bring SANE services to 46 hospitals throughout New York State eligible for the program. The grant, known as the NYS SAFE Telemedicine Pilot Program, was awarded to St. Peter’s Health Partners, who partnered with Virtual ER and telehealth experts, United Concierge Medicine (UCM.)
The key to meeting the needs of these hospitals and victims is SAFE teleconsultation, bringing expert care to these communities. UCM are leaders in the telehealth field, primarily providing emergency medicine telehealth services. UCM staff, a virtual ER team including experienced SANE nurse’s allowing for 24/7 coverage in the new TeleSAFE consultation center. Very few hospitals, particularly in rural areas, have the capability to provide rapid, competent care to sexual assault survivors 24 hours a day / 365 days a year.
When a sexual assault case presents at the emergency department of hospitals participating in the program, the clinical staff on the ground contact UCM’s Virtual ER and the TeleSAFE center to be guided through the examination. A certified SANE examiner will be available within 15 minutes of the call to the UCM call center, it is important to provide immediate care to the patient. The TeleSAFE program reduces the wait time and need to transfer a patient to another hospital, possibly hours away for the examination.
The clinician at the point of care connects to the TeleSAFE center using the EVA (Enhanced Visual Assessment) System. The EVA SANE System is one of the leading visualization and documentation tools in the sexual assault forensic space. EVA combines the capabilities of a video colposcope and a digital camera to enable full body and body cavity image and video capture. With 16x magnification and a built-in light source, EVA SANE provides a high-quality visualization to identify injuries.
The SANE expert in the UCM TeleSAFE center can verify that the evidence collected is suitable for court and that the entire examination is being conducted with the highest standard of medical quality. The UCMnow app embedded into the EVA system allows video/audio connection so that the provider at the hospital is able to hear and discuss with the TeleSAFE consultant. In addition, both sides can mark on the EVA screen what they see and what should be examined more closely.
The EVA System includes both a green light and a high contrast filter which highlights areas of vascularity and can be particularly significant in strangulation cases. Digital images captured by the EVA System can be annotated as they are taken, allowing for a streamlined evidence collection process.
The combination of the NYS SAFE Telemedicine Pilot Program with the connectivity of the EVA System allows for high-quality evidence collection while its teleconsultation capacity helps create a viable telehealth solution for sexual assault forensics. The user-friendly interface on the EVA system allows the technology to be easily adopted even for clinicians who are not accustomed to performing these exams.
The initial funding for the NYS SAFE Telemedicine Pilot Program is for 3 years. In the terms of the grant, a minimum of 15 hospitals were required to participate. The program is exceeding expectations. In a few short months, 12 of the 46 eligible hospitals have joined the program, eager to be able to have a viable and cost-effective method of providing expert SANE services.
As the program develops, it is expected that most of the remaining eligible institutions will be joining, with at least one EVA device present in each hospital.
“The EVA System is handheld..and it’s easier for the nurses to be able to use.”
SANE Program Manager, St. Peter’s Health Partners