As a little girl, Dr. Sonya Brooks, teleneurologist at TriStar Skyline Medical Center, remembers flipping through encyclopedias and being particularly fascinated by human anatomy and physiology. “I just loved trying to figure out how things worked,” she says.

Utilizing technology that’s come a long way since the days when families owned sets of encyclopedias, Dr. Brooks works from home and calls on patients through a live, real time, two-way video interaction that’s similar to Skype — but a whole lot more secure.

We sat down with Dr. Brooks, our newest FACE of TriStar, to discuss technology and medicine and the importance of understanding stroke warning signs.

Dr. Sonya Brooks, teleneurologist at TriStar Skyline Medical Center and our newest FACE of TriStar

What drew you to neurology?

When I was in undergrad, my friend was in a motorcycle accident, and he had quite a bit of brain trauma, so he had to drop out of school. Just knowing someone who had experienced a traumatic injury and trying to figure out how that happened motivated me to go into neurology. When I finished medical school, I went to Vanderbilt to do my residency. After the residency, I completed stroke training, and then I came to TriStar Skyline Medical Center. TriStar Skyline wasn’t a stroke center at that time. A stroke center is a facility that is skilled with training and documentation to be the first stop for potential stroke patients. Dr. Burch, the only other neurologist there at the time, and I started working on how to make this hospital a stroke center. It took time and persistence, but we built it from the ground up, and today, TriStar Skyline is a comprehensive stroke center.

How did you venture into telemedicine?

We had a couple people come in to provide telemedicine demonstrations. We knew that was something we wanted to move toward but didn’t know how that would fit into the big scheme of things. Then, unfortunately, I had a health issue, and it required me to be out of work for a while. When I was well enough to come back, I wasn’t even strong enough to actually walk the halls. I remember Steve Otto [Chief eExecutive Officer at TriStar Skyline] said, “You know what? This is probably a good time to try telemedicine.” While I was at home recovering, I learned this new technology and I loved it.  The first six months were bumpy working out the kinks, but then things just started to fall into place. We continued to grow, and now we cover more than 30 locations across Middle Tennessee, Kentucky and Georgia.

This photograph shows how Dr. Brooks appears to her patients.

This photograph shows how Dr. Brooks appears to her patients.

The doctor is just a phone call away!

The doctor is just a phone call away!

How do you explain the technology and what you do?

It’s similar to Skype in that the patients see me and I see them. Sometimes, they forget that we are talking through the screen because it is that personal. I can zoom in and out, and I can turn the robot to talk to family members in the room. I can show images. If there is an MRI that I’ve looked at, then I can show them the pictures, just like I would if I was at the bedside. It’s a different way of practicing medicine, and it’s almost like taking a board exam every single day. That’s how I explain it to other doctors when they say, “How do you do that when you can’t reach and touch the patient?” So, I just walk them through it. I really have to go through a patient’s history and go through their records. But beyond that, it’s about the same. The thought processes and differentials and reviewing images — all of that is the same. The only downside is I can’t reach through and physically be there in the room with the patient.

What are some of the advantages of teleneurology?

A lot of smaller hospitals don’t have any neurology at all, and it offers them access to a higher level of care. When patients first come into an ER, step one is determining whether he or she can stay there, or do we need to transport to the next level of care. I can’t tell you how many times I’ve been told “I am so grateful that your service exists so that my patient can stay close to home.” That’s incredibly important in the smaller communities. They don’t want to drive a long distance to come to a city for their loved one if their loved one can stay there. The first thing out of their mouths is, “Can I stay here?” Sometimes I have to say, “I wish that you could but your situation is serious, and I don’t think it’s a good idea for you to stay.” With this route, I’m able to help considerably more people than I ever could have physically done. I see people from Georgia, Kentucky and all over Middle Tennessee in an hour, and there is just no way that would be possible without technology.

Now having said that, with facilities that do have neurology, it’s still nice because doctors can call and say, “I have this patient, and I just want to run this by you. Can you take a look and tell me what you see?” It’s just using technology for its maximum benefit, which I think is great. I feel like that’s the way of the future — not even just with neurology. There are so many facilities and so many programs that are benefiting from this type of technology — mental health patients and even pediatrics. I just feel like it opens so many doors that wouldn’t otherwise be available.

With the development of teleneurology, many smaller hospitals now have access to neurology services on behalf of their patients.

Typically Dr. Brooks works from home. But she's clearly right at home in the hospital setting as well!

Typically Dr. Brooks works from home. But she’s clearly right at home in the hospital setting as well!

What challenges do you face in your position?

Sometimes, there’s a little pushback because patients aren’t sure what to expect. Ninety percent of the time I don’t have any trouble, but every now and then a patient will say, “I don’t want to talk to that doctor on the screen.” They don’t realize I’m not in California or just some doctor in the middle of nowhere. I’m local! When I say TriStar Skyline, most people say, “Oh, I know where that is!” I want people to understand that we do have a vested interest in what happens to them, their hospital and heir family — we’re not just strangers in Alaska! The other phrase I get is, “Can she really see me?” Or, “Can she really hear me?” Yes, I can. I’m talking to you right now. So, I want to make strides in helping people understand technology and be more comfortable with it. In so many cases, I believe it makes things faster for everyone. We can see your imaging exams, we can put it up on the screen, and we can show it to your family.

The most important thing Dr. Brooks wants people to know about stroke is the FAST acronym: Face, Arms, Speech and Time

Is there any advice pertaining to strokes that you’d like to share?

Yes! Learn the FAST acronym (Face, Arms, Speech and Time) that describes the warning signs of a person having a stroke. If a family member is concerned enough about you to tell you to go to the ER, then go to the ER immediately. If I had a nickel for each time a family member said, “I told you to come to the ER yesterday.” But, the person didn’t come because they didn’t think something was wrong, and they actually had a big stroke. Just remember that time is your brain! Your family, friends and loved ones care about you, and sometimes they can see things that you don’t. Go to the ER and get it checked out. If you miss your window to have something done, it could potentially impact the rest of your life. Please, do not risk that!

Thank you to Dr. Brooks for your pioneering of new technology for the betterment of healthcare. And thank you to Leila Grossman of Grannis Photography for the beautiful photographs. To learn more about the services offered by TriStar Health, visit tristarhealth.com.