The
Health Services Authority's (HSA’s) state-of-the-art medical robot
is already transforming the way the Authority’s clinical experts
deliver care. An HSA psychiatrist utilizes the robot to provide
continuity of care for her patients while she pursues a
subspecialisation in neuropsychiatry overseas.

Dr
Toni-Ann Heron, who began a one-year subspecialty training programme
in Clinical Neuropsychiatry (MSc) at King’s College London in
September, is using the next generation InTouch Health RP-Lite
4 telemedicine robot, nicknamed 'Sally', to continue providing
care to some of her regular patients here in the Cayman Islands.

Dr
Heron, who sees mainly children
& adolescents, prepared the selected patients for the transition
by discussing what the new teleconsultation format with the Sally
robot would be like. “I explained that not a lot would have changed
– our consultations would still be interactive and confidential,
but I would be communicating with them remotely through a screen on
the robot.”

She
added that many of her patients and their families appreciated the
convenience of this option. “Continuity of care is valuable and
important to doctors and patients. When you have patients with whom
you have built a therapeutic relationship it can be hard for them to
have to switch to another doctor

Dr
Heron started her weekly clinics through Sally robot on 1 October.
She described the experience for her and her patients as a fairly
seamless transition and one that fascinated many of her younger, more
tech-savvy visitors. “Children are now born into a very digital
world, so the transition to a telemedicine platform has largely been
intuitive for them.”

“Psychiatry
is being able to foster that connection with the patient in which
they feel they are in a private setting and are being listened to,”
said Dr Heron. “This was very easy to replicate over Sally robot,
even for the adolescents and older patients who experience anxiety
and depression. It is comparable to our in-person meetings in my
office. Patients and their families have given feedback that they
feel comfortable and I have observed that they disclose as much as
they usually would.”

Another
benefit of using Sally robot is the ability to consult with
physicians at the HSA, including a locum who is providing care to
some of her patients, and engage in case conferences.
“Multidisciplinary collaboration is at the core of paediatric
psychiatry, and reflects the principle of holistic patient care
through the application of biopsychosocial principles to management,”
Dr Heron stated. “Multidisciplinary team meetings involve
consultations with other professionals involved with the child’s
care including other physicians, clinical/educational psychologists,
therapists (eg ABA/occupational), school SENCOs (special education
needs co-ordinators), teachers/other school staff and social
workers.”

Dr
Heron is expected to complete her training in September 2020 and
return to the HSA as its first neuropsychiatrist.

“Neuropsychiatry
is an interdisciplinary field of medicine, at the intersection of
neurology and psychiatry which is critical the treatment of many
persons in our modern society due to mental complications of head
trauma, such as a motor vehicle accident. Neuropsychiatrists may be
involved in the management of patients with a range of conditions
including neurodevelopmental disorders, traumatic brain injury,
epilepsy, autoimmune diseases with neuropsychiatric manifestations,
functional neurological disorders, obsessive-compulsive disorder and
neurodegenerative disorders e.g. Parkinson’s Disease and
Alzheimer’s Disease.,” said Dr. Arline McGill, Head of Psychiatry
& Behavioural Health Services at HSA. “I am elated that Dr
Heron has taken the step to further her education is an area that
will widen the spectrum of patients she sees, as well as
significantly enhance the quality of care she provides to her
patients.”