Christina Thielst, Executive Director of the Northwest Regional Telehealth Resource Center stresses that acute stroke care capacity and services are lacking in many hospitals in the Northwest region, particularly in rural areas. Access to acute stroke care personnel is of particular concern especially in rural areas where only 1 in every 8 hospitals has access to a neurologist either in person or by phone.
Because of this situation, only 53 percent of rural hospitals in the Northwest region have administered t-PA for strokes caused by blood clots—even once in the past year. Emergency personnel often cite the lack of available neurology consultations being given, as one of the reasons for not giving t-PA more often.
Telestroke uses real-time telephone and/or video conferencing technologies to link hospitals to regional stroke centers with specially trained neurologists. The Regional Telestroke Initiative (RTI) representing stroke neurologists, physicians, nurses, clinicians, telemedicine experts, EMS, public health, AHA/ASA and NSA in seven states have just released the results of a comprehensive survey to understand the capacity and use of telestroke care in the Northwestern U.S.
The states surveyed AK, ID, MT, OR, UT, WA, and WY show that an overwhelming 88 percent of respondents said their rural communities suffered from a lack of stroke neurologists. Sixty four percent are currently in the process or considering developing a telestroke program to address this lack of local neurology resources.
Hopefully, the results will help improve stroke care in the region by bringing attention to the rural-urban disparities in stroke treatment and the increasing capacity of rural hospitals to treat stroke patients. The survey results emphasize the need for RTI to continue to help providers improve telemedicine capacity and stroke care services and to take advantage of broadband capabilities to expand telehealth networks.
One of the problems is that upfront costs to providers who implement telestroke programs plus professional consultations are not always covered by insurers, even though they may lead to reduced severity of impairment and future medical costs. The leading sources of funding for organizations providing telestroke services are stroke specialty tertiary (hub) hospitals (28 percent) and grant funding (21 percent). When it comes to reimbursement for a neurologist’s on-call telestroke time, 32.6 percent report that the hub hospital covers the cost, but 32.6 percent report that there is no reimbursement for their services.
Go to http://strokeforum.doh.wa.gov/links/regiona-telestroke-initiative to see the survey results and also for information on the Regional Telestroke Initiative. For more information on NRTC, go to http://www.nrtrc.org/.