Wednesday, March 24, 2010

Stroke Care Produces Results

Crittenden Regional Hospital in West Memphis has partnered with the University of Arkansas for Medical Sciences to provide life-saving emergency care for stroke patients in the region. Using a program called SAVES, the hospital uses a high tech video communications to provide immediate life-saving treatments to stroke patients 24 /7.

The use of real-time video communication enables a stroke neurologist to authorize emergency room physicians to use the blood clot dissolving agent called t-PA. Since the program began, 127 stroke patients have been treated by SAVES neurologists with 23 of those patients receiving the tPA drug with excellent results.

Crittenden is not only partnering with the UAMS Center for Distance Health, but also with the state Department of Human Services, Sparks Regional Health System in Fort Smith and 13 other hospitals in Arkansas. The program is planning to add more hospitals across Arkansas in the coming months, said Curtis Lowery, M.D. Director for the UAMS Center for Distance Health.

In North Carolina, the Comprehensive Stroke Center at Wake Forest University Baptist Medical Center recently expanded their Telestroke Network by adding Ashe Memorial Hospital to the network. The Telestroke system employs a highly specialized telemedicine robot to allow a Wake Forest Baptist stroke expert to evaluate patients and then consult with local emergency room physicians via the internet. Together, they can determine if a patient is a candidate for tPA.

To treat the patient, the stroke physician at Wake Forest Baptist sits at a remote InTouch computer to simultaneously interact with the patient, view medical records, and diagnostic images. Then a connection is made to an InTouch RP-7 robot located at Ashe Memorial which enables them with the help of the robot to move freely around the exam room and interact with patients, family members, and hospital staff.

In another part of the country, the study “Pooled Analysis of the STRoke DOC and STRokE DOC-AZ Telemedicine Stroke Trials” followed two primary hub stroke centers at the Mayo Clinic in Arizona and the University of California, San Diego along with another six rural spoke hospitals.

In the study, 276 patients exhibiting symptoms of stroke at their respective emergency departments were randomly assigned to telephone consultations versus two way telemedicine consultations using a digital observation camera.

Results of the 5 year study showed that the correct emergency stroke treatment decision-making was made 96 percent of the time with the audio/video telemedicine technology as compared with 83 percent for telephone consultations only.

Bart Demaerschalk, M.D., Mayo Clinic neurologist and principal investigator of the Arizona trial, said “This pooled analysis with replication of the hub-and-spoke network infrastructure, supports the fact that telemedicine could be used in broader rural settings and communities in more states in hospitals and with more providers. Results are significant and they confirm the effectiveness of telemedicine to be used as a tool to evaluate acute stroke.”