An increasing number of hospitals and health systems are discovering the benefits of utilizing telemedicine to improve their time of treatment for stroke victims.

According to a study published in the August 2016 edition of Stroke, time to treatment for ischemic stroke victims can be reduced by performing assessments before or during ambulance transport.

The study reviewed the cases of 89 patients with suspected strokes that were treated by Atlantic Health System, a non-profit multihospital system in suburban New Jersey. It determined that door-to-needle time can be shortened by an average of 13 minutes using in-transit telestroke technology.

The study concluded that the time improvements seen by paramedics using the cellular-connected telemedicine devices, combined with the low costs of the system, makes it feasible to provide rapid management of more stroke patients.

Several health systems nationwide have already gotten the memo that telestroke services are effective.

Lee Memorial Health System in Fort Myers, Fla., has a telemedicine program in place that pulls together neurologists from its various hospitals.

As part of a virtual conference hosted by DRG’s HBI Insights, Lee Memorial’s chief information officer, William Carracino, outlined the nuts and bolts needed to develop a successful telestroke program, including two-way high resolution and audio-video interaction, and software and hardware solutions.

Lee Memorial ultimately developed a workable “stroke algorithm” that connects neurologists with the patients. Accomplishments since installation include a reduction in the time needed to administer tissue plasminogen activator (tPA), an FDA-approved medicine that can help reverse an ischemic stroke if given within the first few hours of the episode. The faster a stroke patient can receive treatment, the better the odds of recovery. Lee Memorial has also extended the program from emergency rooms to inpatient floors.

In August 2016, Saint Thomas Health announced it was expanding its Telestroke Network to bring neurology telestroke access to 10 of its locations in Middle Tennessee. With the system in place, Saint Thomas has access to board-certified neurologists 24 hours a day, seven days a week.

Massachusetts General Hospital and Brigham and Women’s Hospital have formed the Partners TeleStroke Center in Boston. Its system has three main components: a brain imaging review, remote examination via video conferencing, and a web portal for synchronized “store and forward” requirements.

Kaiser Permanente evaluated a study of 2,657 patients at 11 of its medical centers in Southern California and concluded the use of tPA increased by a whopping 73 percent following the implementation of a telestroke program. Kaiser released its findings in July 2016.

All told, the body of evidence available overwhelmingly indicates the benefits of a telestroke program. For rural hospitals that may have limited access to neurologists, the system can provide reassurance that an expert can be reached, no matter the physical limitations. And for patients suffering a stroke, the expediency provided could prove the difference between life and death.

 

Follow Chris Silva on Twitter: @ChrisSilvaDRG

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