Sunday, August 16, 2009

Technology Helping Stroke Patients

Ochsner Health System a non-profit academic multi-specialty healthcare delivery system that includes seven hospitals and more than 35 health centers in Southwest Louisiana is going to use the REACH turn-key telestroke and telehealth service to improve stroke care in urban and rural areas throughout the state. REACH is typically installed in hub-and-spoke networks, where neurologists at a larger hub hospital provide consulting services to smaller spoke hospitals for remote stroke evaluation.

Dr. Kenneth Gaines, Chairman of Ochsner’s Neurology Department, notes that all of Ochsner’s spoke hospitals with the exception of rural St. Anne General Hospital are in urban areas, yet not all of the neurologists are on-call, so now REACHs telestroke service will enable patients to receive an immediate evaluation when every minute counts.

He continued to say “most hospitals are developing “spoke” stroke care for smaller rural hospitals, but we see a huge need for urban hospitals where often there are stroke care needs. REACH provides a way to link hospitals without neurologists on-call to the main campus where multiple stroke neurologists are able to manage the telemedicine system on a rotating basis.

CDC recently awarded a three year grant to the LA Department of Health and Hospitals Heart Disease and Stroke Prevention Program to build a telestroke network in collaboration with Ochsner and the American Heart Association. The grant funding will address the lack of access to stroke neurologists and the availability of stroke treating hospitals in Louisiana by developing a regional TeleStroke Network in Southeastern Louisiana to eventually go statewide.

According to Dr. Gaines, the grant covers half of the up-front installation and maintenance costs for any hospital that wants to be involved in this program. The system in place within Ochsner will rapidly expand to rural areas and eventually cover the entire state.

In Wisconsin, The Watertown Regional Medical Center’s telestroke program is the first in the state to provide patients with 24/7 telemedicine access to nationally recognized stroke experts. The doctors at the hospital are using an interactive camera and web technology to perform comprehensive stroke evaluations and are able to determine if a patient should receive tPA treatment.

In Arkansas, the Mena Regional Hospital was one of the first hospitals to join the state “Stroke Assistance Through Virtual Emergency Support” program. The program links rural hospitals to stroke specialists at the University of Arkansas for Medical Sciences and to the Sparks Health System in Fort Smith. The program linking nine hospitals administered by the UAMS Center for Distance Health was established with a one year $6.1 million DHS Medicaid contract.

In a research effort to help stroke patients, Cedars-Sinai became the first medical center in California to use a new clot-retrieval device for patients with acute stroke. The catheter-delivered Penumbra system has been approved by the FDA. The Penumbra device is effective in retrieving clots from blocked arteries in the brain in approximately 80 percent of patients within eight hours of the onset of their symptoms. This has resulted in giving patients a better chance at recovering and the device can be used alone or in conjunction with IV tPA.

Other university researchers are working on devices and systems using technology to help people with strokes. The University of Pennsylvania team was awarded a $2.8 million five-year Bioengineering Research Partnership from NIH to develop an optical cap to monitor the cerebral blood flow in patients with head injuries such as in the case of strokes. The device is able to continuously monitor brain tissue hemodynamics at the bedside.

The cap contains embedded optical pads placed over major cortical blood vessels in each hemisphere of the brain. The system uses optical tomography, photon-counting detectors, radio frequency electronics, data processors, and a computer monitor to display user friendly images of anatomical information to go to physicians and nurses. The system uses diffusing light to detect physiological changes to be able to inform clinicians about treatments.