AcuteCare Telemedicine Blog


A Timely Solution

In the few minutes it takes to read this post, two or more people will have suffered a stroke in the United States. In the Southeast, in what has become known as the ‘Stroke Belt,’ the rate of frequency is at its highest. The need to attack stroke from both a preventative as well as a curative perspective is critical if a  decrease in the incidence and the morbidity/mortality of stroke is to occur.

Over the course of the past few decades, several initiatives to lower the incidence of stroke throughout the nation and particularly in the Stroke Belt have been developed and implemented. Increased education, improved  blood pressure and glucose control,  advised dietary changes etc, have led to a decrease in incidences. What remains concerning, however, is the lack of acute stroke care treatment in many rural areas in states such as Georgia and Alabama. This deficiency is primarily due to excessive travel time necessary to gain access to physicians. Several rural counties in Alabama are altogether without hospitals. “Lack of access to health care is a reported problem in some areas of the state. Some counties have no physician in the entire county. It is difficult for poor rural areas to attract doctors

According to a report in 2010, 44 of 67 counties (in Alabama) did not have a single neurologist. “Some stroke victims have to travel across three counties to access a neurologist for care.” Stroke is the third leading cause of death in Alabama, with nearly 3000 Alabamians dying from stroke each year.

In 2010, only 2 hospitals in the entire state were certified by Joint Commission as Primary Stroke Centers. That number has since doubled, but still remains insufficient, as an overwhelming percentage of the population remains underserved. Although with preventitive measures and education in place, the incidence of stroke should continue to decrease, there will theoretically be no significant change in stroke related morbidity and mortality without timely and appropriate healthcare.

Unfortunately, poor quality health care is deeply and chronically rooted in the infrastructure, or lack thereof, of many of these rural communities. More than 30% of Alabama’s population is situated in these areas lacking equivalent government representation. Fundamental changes in, or the development of new infrastructures within these communities are requisite to create permanent changes in healthcare delivery.

Although not a solution to all of the health care concerns facing states like Alabama, telemedicine does offer an avenue by which cost effective, high quality care can be delivered to residents of rural communities. As pointed out earlier, there is a specific need for neurologic care, given the significant paucity in this area of the country. The implementation of teleneurology programs in these areas would lead to timely neurological consultations and care that would otherwise not be available. Where time equals brain cells in the case an acute stroke, expeditious treatment via teleneurology can literally be life saving. Teleneurology would help to improve not only quality of health in rural communities, but also quality of life. When a healthcare facility earns primary stroke certification (an initiative for which teleneurology programs can offer assistance), it typically sees a growth in ER volume and admissions, subsequently increasing revenue. Jobs can be created as a result of this growth, which in turn can help jumpstart  local economies.

Telemedicine alone will not solve all of the health care issues in rural Alabama and other similar regions in the stroke belt. However, these solutions can immediately fill a desperately missed need. Remember the two people in the United States who will have had a stroke in the time it took to read this article. The question is, will a neurologist have been able to reach them?

 


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