As part of their mission, LIG is committed to finding low cost high value technologies that support their efforts to improve patient care. As an example, in 2017 the LIG team brought a Philips Lumify on their surgical mission to the Dominican Republic for the first time. Dr. Sarah Timmapuri, CEO of LIG and a practicing cardiologist said, “Lumify was an invaluable adjunct to our work. Not only were we able to perform focused 2D echocardiograms on our pre-operative evaluations, we used the Lumify for a wide variety of ultrasound exams including abdominal, GYN, breast, urological and soft tissue. Additionally, we were able to perform ultrasound-guided regional nerve blocks for postoperative pain management”. The added information from Lumify changed our patient care plan several times. We can't stress enough how invaluable the Lumify was to our program.
In the post-operative setting Lumify was used to perform ultrasound-guided transversus abdominus plane (TAP) blocks for pain management. Due to existing hospital staffing and resources, options for overnight pain management were limited. Ultrasound-guided TAP blocks provided long acting analgesia to keep patients comfortable through the night. This proved to be particularly helpful for patients who had undergone significant surgeries such as abdominal hysterectomy, open cholecystectomy, and ventral hernia repair.
The clinical utility of Lumify made an even bigger impact on LIG’s surgical mission trip to the Dominican Republic in June 2018 because of the integration of Reacts, a remote communication platform that can connect personnel at separate locations for applications such as virtual teaching and training. “Lumify has proven to be an indispensable asset to our activities at the Ramón Mella Hospital in Dajabón” said Dr. Sarah Timmapuri. “This year, its utility was expanded by the incorporation of the Lumify with Reacts”.
Focused echo exams were done using the Lumify Reacts tele-ultrasound feature, this provided real-time two-way video and audio with live streaming of the ultrasound image. Dr. Dan Hogenauer, who was on-site in the Dominican Republic, acquired images under the real-time virtual guidance of a Dr. Timmapuri, a cardiologist sitting in New Jersey. Dr. Hogenauer and Dr. Timmapuri were able to consult using Lumify with Reacts.
As an example, a patient in his fifties with hypertension was evaluated for an elective hernia repair. He presented with no specific cardiac complaints and had a normal cardiac rhythm on telemetry. However, a focused echocardiogram using Lumify revealed severe global left ventricular hypokinesis (with a visually-estimated ejection fraction of less than twenty percent), left ventricular enlargement (LVIDd ~ 6.7 centimeters), severe mitral regurgitation and a small complex, circumferential pericardial effusion. Because of these findings, the patient was determined to be at high surgical risk. The patient’s surgery was canceled and he was referred to a local cardiologist for follow up care. However, using the Reacts platform on Lumify, Dr. Timmapuri was able to provide consultation from New Jersey, and speak to the patient and his family in the Dominican Republic immediately following the echo to explain the results and recommendations.
The Lumify system continues to be an essential tool for the LIG missions in the Dominican Republic. The addition of the Reacts platform allows for efficient communication between their cardiologist in the United States and their radiologist on the ground. The Lumify system allows the team to evaluate more patients and deliver immediate decisions at the point-of-care.