Advancing Stroke Care With Telemedicine

Compiled by Katie Wike, Contributing Writer

Telemedicine provides hospitals with the on-demand neurological expertise necessary to accurately assess stroke patients, saving lives in the process.

When a patient presents with symptoms suggestive of acute stroke, “time is brain” since every minute nearly two million nerve cells can die. The American Stroke Association gives clear guidelines for quality treatment of acute stroke, which focus on medical decision-making on administration of intravenous thrombolytic treatment within 60 minutes of the patient’s arrival at the emergency department (ED). Unfortunately, many EDs don’t have a seasoned neurologist on hand to assess stroke patient conditions 24/7. Telemedicine now makes this one-time luxury very attainable for hospital EDs and outpatient facilities of any size. The use of videoconferencing and other remote monitoring applications allow a neurologist to be at a patient’s bedside within minutes — at least virtually. Telespecialists is a physician service organization consisting mostly of neurologists and intensivists dedicated to providing all healthcare facilities in need with immediate neurological consultations via telemedicine. According to Dr. Nima Mowzoon, a neurologist and CEO of Telespecialists, being able to react quickly is a valuable asset to any quality stroke program.

Q: How are your services delivered?
A: Outpatient appointments are scheduled by the office. However, we also have several physicians on call who take emergency telemedicine calls. There are telemedicine stations at our locations and most of our solutions are cloud-based.

Q: What technologies do you use to deliver physician expertise ondemand to other healthcare facilities?
A: We have used different platforms. For example, InTouch Health [a provider of acute-care telemedicine solutions including high-acuity consults where immediate clinical action is required] allows us to use the built-in stroke program for easy consultation for stroke patients. When we add a facility, we complete an assessment, which allows us to better understand which technology best fits the location. With InTouch Health, we are able to use laptops that connect to larger monitors and use the cloud to retrieve images from PACS.

Q: What challenges do you encounter working with other health providers?
A: Some healthcare providers view telemedicine as a replacement for physicians’ services, but in reality telemedicine is an extension of the clinical services already being provided. It makes the service line more efficient and timely. This is particularly important in areas where there is a shortage of neurologists. In many rural hospitals that are completely void of specialists, telemedicine is highly needed. Unfortunately, there is very little funding in those hospitals to support these programs.

Q: What other technologies are you evaluating?
A: Due to the low margins that many hospitals operate on, particularly rural hospitals, we always evaluate affordable solutions to technology problems. For instance, we are currently evaluating robotic telepresence solutions from VGo Communications.

Q: How have your telemedicine services proved invaluable to hospitals and their patients?
A: We have implemented a program, “Lean Value Stream Mapping,” which allows integration of the telemedicine program into the different hospitals and hospital systems with individual needs and characteristics. With this project, our treatment protocols have dramatically improved, particularly for stroke patients. For example, we have seen administration of the clot-buster medicine after 30 to 40 minutes.