What is TeleStroke?
Visit the below links for more information on the TeleStroke process and the many benefits this service provides.
The Burden of Stroke
In developed countries, stroke is the third leading cause of death. Each year, stroke occurs in more than 700,000 patients, leaving many with disabilities and unable to resume their previous lifestyle or employment. This makes the social and economic impact of stroke one of the most devastating in medicine.
View sample clips of the NIH Stroke Scale exam, recorded from actual TeleStroke patient consultations. [ View Clips
There is an FDA-approved medicine (tissue plasminogen activator, tPA) that in some patients can help reverse the
disability of stroke if given within the first 3 hours of stroke.When it comes to the assessment and treatment of stroke patients,"time is brain".
The faster a patient receives proper treatment for stroke, the better the chances for recovery.
The Partners TeleStroke program could be an important component of your patients’ stroke care by helping you to rapidly evaluate and treat stroke patients.
Please visit one of the links below for more information.
Helping Patients From Afar
By establishing a telemedicine link using videoconferencing and image sharing technology, stroke specialists from Brigham and Women’s and Massachusetts General Hospitals can examine patients at remote hospitals miles away
to help diagnose the patient's ailment and recommend a plan of care.
80% of strokes are ischemic strokes - an affliction in which a blood clot, formed in another part of the body, travels to a smaller blood vessel in the brain and becomes lodged, blocking the blood flow to that area.
"Patients are arriving at smaller community hospitals who are candidates for this clot buster therapy and in some cases may not be getting it."
One form of treatment is to administer Tissue Plasminogen Activator (tPA), a clot busting drug that can greatly reduce the disability resulting from a stroke. tPA must be administered within 4.5 hours of symptom onset.
Unfortunately, some hospitals lack the resources to make this determination and cannot physically transfer the patient quickly enough to enable them to receive this therapy if warranted. This is where TeleStroke comes in. Subscribing hospitals can receive acute stroke care for patients without physically transferring the patient for an exam.
"I can examine someone very interactively with the help of a physician or a nurse on the other end and I can make a determination of the stroke severity and the type of stroke by looking at the patient and at the brain image," Dr. Schwamm said.
"It's almost like being in the room."
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The telemedicine system has three components: a brain imaging review, remote examination via video conferencing, and a web portal for synchronized "store and forward" requirements.
Interpretation of the brain images (CT scan) is a vital part of the acute stroke evaluation. The brain imaging review allows a Partners stroke physician to download and view brain scans from the remote hospital. Since the scans are available, the Partners stroke physician will be able to see subtle findings on the CT scan, thus helping to determine which patients qualify for thrombolytic therapy.
"Its great to have people from Partners literally walking us through the exam so we can get these patients to a tertiary center as quickly as possible."
The video conferencing component allows the physicians to collaboratively perform the NIH-MGH Stroke Scale, which represents the severity of the stroke and supports a diagnosis of stroke that may lead to further treatment.
This informed consult allows physicians to recommend treatment quickly and in stroke care, as Dr. Schwamm describes it, "Time is brain".
Aside from the web portal, all of the technical components are commercially available. The video and the sound components travel via high speed, ISDN telephone lines, or IP based technologies. Data compression technology is utilized to transmit the images.
A Sample Case
A patient presents to the remote hospital's ED with a possible diagnosis of acute ischemic stroke. The local stroke team is activated and brain imaging is performed. The patient is then considered for remote consultation. This patient might be a candidate for thrombolytic therapy, utilizing either intravenous (IV) or catheter based methods, or someone in whom acute stroke expert management consultation is desired.
If remote advice is desired, the patient signs a consent form allowing them to be evaluated over the video conferencing system. This authorization is forwarded to your provider and kept on file.
With the help of the referring ED, the stroke specialist conducts a brief neurological exam of the patient. Upon completion, they then review the brain imaging. The findings are discussed with the remote physician and together they collaboratively decide on a plan of care.
The acute stroke evaluation and recommendations are placed on the secure TeleStroke Center web site, where the referring physician can access them. This document can be printed and placed in the patient's medical record at the referring facility.
Follow-up consultation is also available for further treatment decisions and secondary stroke prevention recommendations.
Read Testimonials from our members, news articles about the program, or contact us for more information.
Links and Media
View or subscribe to feeds for the latest articles about stroke from the Google news service.
Stroke related news
American Heart Association
The Association is a national voluntary health agency whose mission is to reduce
disability and death from cardiovascular diseases and stroke.
American Stroke Association
American Heart Association division established in 1998 to reduce the impact of stroke.
National Stroke Association
At National Stroke Association (NSA) we are committed to providing you with the information and tools you need to prevent and treat stroke in your patients -- no matter where you work along the continuum of stroke care.
The National Institute of Neurological Disorders and Stroke (NINDS) conducts and supports research on brain and nervous system disorders.
Washington University’s Internet Stroke Center
An independent web resource for information about stroke care research.
Videoconferencing equipment supplier to Brigham & Women’s and Massachusetts General Hospitals, as well as to many of the member hospitals.