It was Shakespeare’s Richard III that introduced ear, nose and throat surgeon, Dr Jonathan Livesey, to the world of voice.
Now it is Visionflex’s powerful telemedicine platform – the ProEX Telehealth Hub – that helps him care for his patients in his busy Sydney voice clinic.
In 1992, while training as an ENT in the United Kingdom, Dr Livesey spent time with speech pathologist and Royal Shakespeare Company voice consultant, Professor Paul Carding.
The understudy for Richard III came to Professor Carding’s clinic, concerned that his voice wouldn’t cope with eight performances per week while covering for the ‘real’ Richard III who was in hospital.
“The question was,” explained Dr Livesey, “how to examine Richard III, work out what was going on, reassure him and treat him so that he could do his job…and that was my introduction to voice.”
Since 1998, Dr Livesey, who is one of only a handful of voice specialists in Australia, has operated a successful voice clinic, called Voice Connection, in St Leonards on Sydney’s North Shore. His multi-disciplinary team includes two speech pathologists and two psychologists. They treat all people with voice problems ranging from singers and actors to doctors, lawyers, teachers, parents, and children.
Dr Livesey also runs general ENT practices in the Sydney suburbs of St Leonards, Mosman and Dee Why.
Central to his voice clinic is Visionflex’s ProEX Telehealth Hub.
Updating the practice archiving system with the ProEX Telehealth Hub
Dr Livesey wanted to update his practice’s ageing video archiving system with a modern digital solution that could easily connect to his existing medical camera – an Olympus distal-chip HD fibre-optic laryngoscope and strobe light – without requiring the expensive purchase of new cameras and peripheral devices.
In addition to watching the HD examination in real time with his patients, Dr Livesey needs to be able to store a record of the examination in his secure server for future reference; to email a copy to other medical colleagues if required; and to provide a USB copy for patients to show their family and friends, their singing teacher, or other clinicians.
Dr Livesey also required a system that integrated seamlessly into his practice management software (Genie); a system that was user friendly and compact; and importantly, a system that came with responsive technical support during the installation period.
The state-of-the-art Visionflex ProEX Telehealth Hub has helped Dr Livesey update his practice’s video archiving system, while continuing to use his existing laryngoscope, which he simply connects to the unit via a HDMI port.
The power of the ProEX
The ProEX’s powerful software provides real-time HD-image resolution, along with footswitch control and sophisticated recording tools to facilitate accurate ear, nose and throat examinations and diagnoses.
The compact and sleek unit is easy to use with an integrated touchscreen, a remote control, and an external keyboard (wired or Bluetooth®), which can be used to annotate patient images and videos. The live feed can be watched from both the ProEX’s large HD screen, and full HD monitors.
The unit has multiple ports for optimum connectivity including HDMI, USB, DVI, CVBS and S-Video inputs, as well as LAN, Bluetooth® and WiFi capability.
“From an ENT perspective, I’m very impressed with the ProEX,” said Dr Livesey. “We can use it to record things easily and play them back; then download it to our office software easily, record it on a USB and give it to a patient or email it to another clinician. The unit’s interconnectivity is fantastic.
“The ProEX is easy to run and my colleagues in the voice clinic can operate it themselves; it’s not a complicated computer to set up – it’s one unit with a very small number of buttons and is intuitive which is helpful.
“I think it’s an excellent product and I think the cost of it is very good compared to other systems that are available.”
The ProEX supports a range of digital and analogue medical examination devices including endoscope cameras, LED light sources, ECG, ultrasound, stethoscope, pulse oximeter, blood pressure, IR patient thermometers, and the Visionflex GEIS® General Examination Camera HD.
The ProEX’s synchronisation with practice management systems ensures that patient information is automatically stored and shared securely for future reference and review. All patient data is encrypted to comply with HIPAA requirements.
While Dr Livesey doesn’t use the ProEX for telehealth applications in his own practice, he says its lightweight, compact design makes it highly portable for ear, nose and throat specialists who visit remote patients.
“It gives people the opportunity to connect via very clear video in real time; upload clinical information and get real answers back. I think it is superb.”
Dr Livesey, who has known Visionflex CEO, Mr Mike Harman, for many years, says the technical support Visionflex provided during installation made integrating a new telemedicine system into his practice seamless.
“I’ve always had an extremely good relationship with Mike. He’s very personable and he’s always interested to know how we, as clinicians, and he, as a service provider, can work together to provide what clinicians really need.”
The ProEX Telehealth Hub – providing ENT specialists and patients with a crisp HD image
To examine his voice patients, Dr Livesey carefully inserts a laryngoscope through their nose to look at the larynx, while the patient performs some voice exercises – usually, this is the first time they have ever seen how their voice works.
“They can see their larynx on the screen and sometimes they’ll go, ‘Oh, is that what it looks like?’,” said Dr Livesey.
“Or, if they think they have nodules, see on screen that they haven’t, their shoulders visibly drop as they relax. The ProEX is a very good system.”
Dr Livesey’s clinic takes a wholistic approach to voice: a small number of patients may require laryngeal surgery; most require speech pathology to learn how to “use their voice more efficiently”; while other patients may need to work with the clinic psychologist to overcome psychological issues and stressors that impact voice.
“If the eyes are the window on the soul, the voice is the soul being heard” said Dr Livesey.
Dr Livesey was a founding member and past secretary of the Laryngology Society of Australasia (LSANZ). He was a founder member of the Australian Society for Performing Arts Healthcare (ASPAH) and was a past president of the Australian Voice Association (AVA).