AcuteCare Telemedicine Blog


The Importance of Measuring Performance

Telestroke, the use of communication technology to remotely treat victims of acute stroke, continues to grow and has entered the mainstream of care in an ever evolving and increasingly disruptive healthcare delivery model. Like all medical innovations, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Merely asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited re-sources is laudable but insufficient.

AcuteCare Telemedicine (ACT), a leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care, understands the importance of evaluating and documenting telestroke performance. In their recently published study “Improving Telestroke Treatment Times in an Expanding Network of Hospitals” the authors reveal that a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency.

“Success in our business isn’t just about adding new healthcare organizations to our client portfolio,’ says Dr. Matthews Gwynn, co-author and ACT partner. “As clinicians, we measure our success on consistently providing the highest level of stroke care and improving patient outcomes. This study is representative of our ongoing commitment to serve as a leader in telestroke care, establishing a standard of care and a model that supports the positive growth of telestroke programs across the country.”

As virtual health initiatives continue to move forward, new and valuable trends and telehealth technology solutions will continue to emerge. Traditional methods of delivering medical care will be challenged and disrupted at medical facilities, physicians’ offices and hospitals. Dr. Keith Sanders, ACT Partner and co-author comments, “It is critical to prove that our business is able to create telestroke programs that are not only effective but sustainable.”

For more information on how AcuteCare Telemedicine can assist you with acute stroke care, contact us!



Robots and Doctors Help Improve Stroke Treatment

The issue of delivering consistent medical care across all geographic areas from large populated urban centers to the outlying rural communities has been a critical area of focus for healthcare organizations. Typically smaller, financially stressed rural hospitals and clinics suffer from limited access to medical specialists, particularly in emergency situations involving stroke and other neurological and coronary events. These medical emergencies demanded quick and immediate treatment to save the affected patient from significant disability or death.

In the three years since the first telestroke robot was installed at Covenant Health Hospitals in East Tennessee, doctors at LeConte Medical Center (LMC) have used the technology on a weekly basis. Using the latest in virtual presence technology the dedicated medical professionals at LMC can connect immediately with a team of neurological specialists at AcuteCare Telemedicine in Atlanta, GA. “It’s an amazing thing that we have this expertise in a small rural hospital,” said Steve Dronen, M.D., Emergency Room at LeConte Medical Center. While the hospital has a well demonstrated history of providing quality care to stroke patients, the extra advantage of having highly trained and experienced neurological specialist available for consultation around the clock, 24/7 assures LMC patients the highest level of stroke care available anywhere in the country.

Dr. James Kiely, a partner in Atlanta Neurology, P.C. and AcuteCare Telemedicine said, “As Medical Director of the Neurophysiology Departments at St. Joseph’s Hospital of Atlanta I was aware of how fortunate our patients were to have the most immediate lifesaving treatment for stroke 24 hours a day, seven days a week.” The most effective stroke care requires that it be delivered to the patient within the “golden window” of stroke onset. With stroke being the number four cause of death and a leading cause of disability in the United States, lack of access to neurologists who specialize in stroke care threatens to deprive many patients the best chance of recovery after a stroke. “AcuteCare Telemedicine was created”, Dr. Kiely says, “to impact the well-being of patients with severe neurological emergencies who otherwise wouldn’t have rapid access to vital expertise simply because of where they live.”

The other major benefit of the technology, described by Dr. S. Arthur Moore, Medical Director of Stroke Program at Covenant Health’s Fort Sanders Regional Medical Center, is how quickly the tele-robot allows doctors to make life-saving decisions. “We can now do something about it. It doesn’t matter if you are in rural East Tennessee or in Knoxville, we can provide the same care,” said Dr. Moore. Doctors only have a small window of time to make a treatment decision before the damage from stroke becomes permanent. The new technology is helping to accelerate the treatment process.



Best Integrated Campaign for Stroke Month Awarded to Bon Secours Richmond

ACT Blog Bonsecour Award

From Left to Right: Bob Silverstein, Enterprise Executive Sales Director, ACT; Dionne Henderson Director of Community & Multi-Cultural Initiatives at American Heart Association, American Stroke Association; Patricia C. Lane MBA, SCRN|Bon Secours Richmond Administrative Director Neurosciences, Bon Secours Richmond Health System; Dr. Stacey Epps, Executive Medical Director Bon Secours Virginia Neuroscience Institute.

The American Heart Association/American Stroke Association recognizes American Stroke Month by focusing on efforts to teach family, friends and coworkers how to recognize the signs of stroke.

This year The American Heart Association awarded Bon Secours Richmond Health System the Best Integrated Campaign Award for 2015. The fourth largest and only faith-based health system in Virginia, Bon Secours Virginia provides full range of services to thousands of Virginians through a network of hospitals, primary and specialty care practices, ambulatory care sites and continuing care facilities across the Commonwealth.

Bon Secours is accustomed to taking a leadership role in Neurological care, having established teleneurology initiatives more than five years ago with a goal to have all of its area hospitals joint commission certified. AcuteCare Telemedicine, the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care is collaborating with Bon Secours Neuroscience Institute (BSNI), the neuroscience division at the not-for-profit Catholic health system sponsored by Bon Secours Ministries.

Dr. Keith Sanders, Partner, AcuteCare Telemedicine, comments, “ACT is aligned with Bon Secours and its ongoing commitment to utilizing the finest and latest technology for the treatment of stroke. This award is evidence of their outstanding efforts to promote a fully integrated stroke program that improves awareness of the dangers of stroke and provides the best in acute stroke care to the communities we serve.”



AcuteCare Telemedicine Announcing New Partnership with Bon Secours in Collaboration with InTouch Health

 

AcuteCare Telemedicine, the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care, announces its newest collaborative partnership with Bon Secours Neuroscience Institute (BSNI), the neuroscience division at the not-for-profit Catholic health system sponsored by Bon Secours Ministries.

Bon Secours first established teleneurology initiatives 5 years ago at its smallest hospital, Richmond Community Hospital, with a goal to have all of its area hospitals joint commission certified. Patricia Lane, Bon Secours Richmond Administrative Director of Neurosciences says, “Working with the AcuteCare Telemedicine partners feels like an extension of the internal practice. They are truly in alignment with Bon Secours efforts to identify the right path to create continuity of care from the time the patient is admitted to our Emergency Room to the time they leave the hospital. AcuteCare is not just a provider, but invested team members who take pride in providing the best quality of neurological care to our patients.”

By utilizing innovative telecommunication technology, BSNI patients are able to undergo remote consultation with AcuteCare Telemedicine neurology specialists in Atlanta, Georgia. Dr. Matthews W. Gwynn, CEO AcuteCare Telemedicine says, “The neurologists of AcuteCare Telemedicine look forward to helping the Richmond and Kilmarnock areas achieve even greater quality in emergency care for their neurological patients through timely, professional medical consultations using the latest advanced communication technology with our partners at InTouch Health.”

AcuteCare Telemedicine is collaborating with InTouch Health to bring 24/7 extended teleneurology services to BSNI. InTouch Health provides technology enabled services to healthcare providers for the delivery of high-quality clinical care virtually anywhere, anytime. The InTouch® Telehealth Network enables healthcare systems to deploy telehealth applications across their enterprise. Patricia Lane comments, “I just love the technology and clinical solutions platform. It allows for continuity in communications from doctor to doctor and permits the real-time sharing of information between care-givers. Our ultimate goal is to provide a better treatment plan for each patient. AcuteCare Telemedicine and InTouch are the right solution to attain our goals and objectives with our teleneurology initiatives.”

Yulun Wang, Chairman & CEO, InTouch Health said, “We are honored to partner with the Bon Secours Health System to bring greater access to quality care at lower costs into the communities they serve.  InTouch Health’s enterprise-wide Telehealth Network, in combination with high-quality remote physician services, can touch more of Virginia’s population through Bon Secours’ extensive network of hospitals and ultimately into ambulatory care facilities, clinics, long term care and patients’ homes.”

AcuteCare Telemedicine continues to expand its geographic imprint in telestroke care, and is very excited for the opportunity to drive impact for Bon Secours as they continue to enhance their telestroke network. “The advancements in teleneurology not only allow us to access more patients in need of our specialized care, but also improves patient outcomes overall,” comments Dr. Keith Sanders, COO, AcuteCare Telemedicine. “The success of any program hinges on a seamless execution from door to needle. This collaboration is sure to have a significant impact on the patients and communities it serves.”

For more information on AcuteCare Telemedicine, visit www.acutecaretelemed.com.

 

About AcuteCare Telemedicine 

Founded in 2009, AcuteCare Telemedicine is a limited liability corporation advancing the opportunity for healthcare institutions to gain access to highly-respected, expert neurologists and telemedicine technologies. AcuteCare offers a range of services including first-rate neurological emergency response care with around-the-clock support and hospital accreditation education. AcuteCare primarily provides remote emergency neurology consultation which fills staffing needs and reduces the costs associated with 24/7 neurologist availability. As a result, healthcare institutions provide full service emergency neurology care and can earn Joint Commission Certification as a Primary Stroke Center. 

About Bon Secours Virginia Health System

Bon Secours Virginia provides good help to thousands of Virginians through a network of hospitals, primary and specialty care practices, ambulatory care sites and continuing care facilities across the Commonwealth. The not-for-profit health system employs more than 12,500 people, including nearly 800 providers as part of the Bon Secours Medical Group.

The fourth largest and only faith-based health system in Virginia, Bon Secours Virginia offers a full range of services including cardiac, women’s, children’s, orthopaedics, oncology, neurosciences and surgery at eight award-winning hospitals.

– Bon Secours Richmond is St. Mary’s Hospital, Memorial Regional Medical Center, Richmond Community Hospital, Rappahannock General Hospital and St. Francis Medical Center.

– Bon Secours Hampton Roads is Maryview Medical Center, DePaul Medical Center and Mary Immaculate Hospital. 

About Bon Secours Virginia Health Care Foundation

The Bon Secours Virginia Health Care Foundation raises charitable funds to help Bon Secours Virginia Health System address the community’s growing health care needs with compassion and excellence. Through charitable support, we are dedicated to helping create healthy communities, advancing clinical innovation and providing an extraordinary experience of care. For more information on giving, visit www.bsvaf.org. 

About InTouch Health

InTouch Health provides technology-enabled services to healthcare organizations for the delivery of high quality virtual care, anytime, anywhere.  InTouch Health has helped more than 100 healthcare systems deploy telehealth programs across their enterprise, and into other sites of care, quickly and seamlessly using its industry-leading combination of professionals, processes and practices.  The InTouch Telehealth Network provides users unmatched ease of use and diagnostic capabilities, proven reliability, FDA and HIPPA compliance, secure access control, and clinical and technical reporting.



Telemedicine Legislation is Moving; In All Directions

The use of telemedicine and telehealth is increasing becoming the subject of debate in state legislatures all across the country, making the delivery of medical care via telecommunication technology a priority legislative issue for 2015. Ten states; Arizona, Arkansas, Connecticut, Montana, New Hampshire, New Mexico, Oklahoma, Virginia, West Virginia and Wyoming are moving legislation that will impact how their state licensing boards enforce established clinical practice standards. In Arkansas, Connecticut, Indiana, New Jersey, Rhode Island, and Washington law makers are considering legislation that will require telehealth parity under private insurance.

Ron Bachman, a foremost expert on health care consumerism, consumer-centric Medicaid and Medicare, the uninsured population and mental health, predicts an estimated half a billion smartphone users worldwide will be using a health care app to connect to a healthcare giver by the end of 2015. An emerging, technology-using generation is becoming increasingly comfortable with using mobile devises to access their medical care through smartphones, tablets and laptops. Entrusted with an increased responsibility for paying the rising costs of healthcare, these new consumers are embracing disruptive technologies to command lower cost, more convenient, higher quality, consumer oriented medical care. “It is impossible to stop a mega-trend,” says Bachman. “Telehealth is the cutting-edge future of health care worldwide. Telehealth, in its various forms, will provide convenient medical services because consumers will demand it.”

In another recent Harris survey, more than half of Americans indicated that they want to use telemedicine to connect with a physician, and they also think it should cost less than an in-person visit. It is an indication that consumers identify telemedicine as a different means by which to deliver care not a different type of healthcare. Data consistently indicates that telemedicine can deliver quality healthcare outcomes comparable to in person office visits while lowering consumer costs for routine care. Emergency Room (ER) treatment tops the list as the most expensive, least efficient and most frequently utilized way to provide non-emergent care, with an ER visits costing from $1,500 to $3,000 on average. Visits to a Primary Care Physician (PCP) can coast from $130 to $190. A telemedicine visit can cost as little as $40. With the popularity among voting consumers growing there is little wonder why state lawmakers are aggressively marching telehealth legislation forward.

In a recent Forbes article entitled, “Telemedicine Is a Game-Changer for Patients, The System,” contributor Bill Frist points out that there are multiple barriers to the widespread uptake of telemedicine with the most prohibitive being regulatory policies at the state level. The laws in many states either severely limit or completely ban the practice of telemedicine. In Frist’s opinion, for consumers to gain the most benefits from telemedical technology legislation must address four persistent barriers to complete telehealth adoption:

The legislation needs to provide payment parity by requiring insurers to reimburse licensed health care providers for services delivered remotely at the same rate they would pay if the visit were in-person. This assures there would be no financial incentive to favor face to face care over telemedical services. The caveat that it cost the same acknowledges the value of the telephysicians expertise and the indirect costs of providing this service. Cost savings would still be realized through a reduction in lost workforce productivity and less reliance on emergency medical services.

For quality assurance, any legislation should establish that the same standard of practice applies whether the services are delivered in person or remotely.

Proposed legislation should prevent the use of additional rules requiring in person visits before or after telemedicine encounters or the presence of care facilitators during an encounter. Such restrictions effectively eliminate the possibility of most telemedicine models from operating.

State licensure requirements should allow exemptions for telemedicine.

The legislation that is passing through some states is attempting to encompass many of these points. The Arkansas House of Representatives was able to pass a new bill (SB133) that is more restrictive than one that had been previously voted down. While the bill does not meet all goals of an open telemedicine market for consumers and provider alike, it will allow telemedicine practitioners to be licensed as doctors in Arkansas, waives the requirement for a pre-existing, in-person relationship with the patient in cases of emergency and demands that telemedicine be reimbursed by Medicaid and private health plans.  Arkansas lawmakers, like those of many states, are finally willing to open the door to a new healthcare delivery model by way of modern technology, if only a little.

Other states have also passed or are considering telemedicine legislation that would expand telemedicine within their states. There appears to be little consistency in the various offerings except for a tendency towards over-regulation and complexity. Telehealth is exactly the type of innovation that can solve many of the challenges currently facing the healthcare system. Elected representatives must move more vigorously to craft legislation that serves to promote this innovation while limiting litigiousness and overregulation.



Researchers Use Telemedicine to Identify Patients for Clinical Trials

Using telecommunication technology to advance the delivery of healthcare is nothing new. Each day telestroke programs are demonstrating their value to patients who suffer acute ischemic stroke, particularly for those patients who live their daily lives beyond the easy reach of advanced urban healthcare centers. Well-developed “spoke and hub” telestroke programs at small to mid-sized hospitals throughout rural areas are providing advanced life-saving and quality of life benefits to thousands of stroke victims who once were just too far removed from medical specialists to benefit from the most specialized treatment. Advancements in telecommunication technology and its application to delivery medical treatment (telemedicine) are revolutionizing the healthcare delivery model by bringing the care-givers and the treatment to the patient no matter where they reside.

But a major new step in the approach to conducting clinical trials has been taken at the University of Texas Health Science Center at Houston (UTHealth). By utilizing telemedicine to remotely enroll patients with acute stroke in a new study being conducted at different hospitals, researchers are now bringing the research and clinical trials to the patients. The virtual enrollment of patient participants by a group of researchers at Baptist Beaumont Hospital and Memorial Hermann Southwest Hospital will help overcome limitations in the scientific process of testing therapies. The results of the study entitled “Telemedicine-Guided Remote Enrollment of Patients into an Acute Stroke Trial” were recently published in the journal of the American Neurological Association, Annals of Clinical and Translational Neurology. The research team identified 10 candidates and remotely enrolled six of them in a randomized, phase III study.

“One of the main drawbacks of conducting clinical trials for stroke is that we traditionally are limited to patients who arrive at large stroke centers that have the expertise to treat stroke quickly to minimize damage to the brain,” explained the first author of the study and director of the Telemedicine Program, Tzu-Ching Wu, MD. The trial was led by the associate professor of neurology at UTHealth and senior author of the study, Andew Barreto, MD. Patients were identified, screened, enrolled and randomized remotely. “Instead of the patients having to be taken to the mother ship, we brought the study to the patient. The implications are enormous,” Dr. Wu said. “This opens the doors to clinical trials for everyone and helps move science along. Because of the amount of stroke trials that are conducted, it’s hard to find enough participants. This allows us to widen the pool.”

Research and prevention efforts over the past decade have contributed to the decline in the mortality rates for stroke, but the disease still impacts approximately 800,000 people each year and remains the fourth leading cause of death in America. With the aging of the population, stroke research and clinical trials remain a vital determent to the upward progression of the disease. Telemedicine promises to have a significant impact on acute ischemic stroke and is likely to result in further declines in stroke mortality. Using telemedicine technology to assist researchers in broadening access to stroke patients for research purposes may lead to more opportunities to unlock new and beneficial treatments for the disease.



AcuteCare Telemedicine Advancing Stroke Care

A little more than a decade ago, telestroke and teleneurology were words that where not even part of our language but today are synonymous with the delivery of life-saving treatments for stroke. In a time when medical specialist are in short supply  among the nations smaller to mid-sized hospitals and increasing financial pressures make maintaining a neurology service difficult even at larger hospitals, many are turning to telestroke programs to assure their patients have access to the finest quality care available.  “Attracting and recruiting medical specialists is an ongoing challenge for smaller, regional hospitals who must balance the needs of their patients with the financial realities of healthcare in this demanding economy,” says Dr. Matthews Gwynn, Director and Founder of the Stroke Center of Northside Hospital in Atlanta and AcuteCare Telemedicine CEO. The combination of improving patient care, a growing shortage of neurology specialist and concerns over rising healthcare cost have converged to produce a significant increase in the utilization of communication technologies in the delivery of advanced stroke care

In a recent study, telestroke units helped increase the number of rural stroke patients treated and delivered treatment faster. In the 10-year evaluation of telestroke programs the study, published in the journal Stroke, found that the number of patients receiving the clot-busting drug tissue plasminogen activator (tPA) for ischemic stroke rose from 2.6 percent to 15.5 percent and the median time between a patient’s arrival at a regional hospital until tPA was administered fell from 80 minutes to 40 minutes. In addition, the median time between onset of stroke symptoms and receiving tPA fell from 150 minutes to 120 minutes. During the same decade, the number of patients transferred from regional hospitals to stroke centers declined from 11.5 percent to 7 percent.

Telemedicine continues to make significant progress in providing quality, specialized care for stroke and other neurological ailments and is improving access to this care for patients who live in remote outlying areas not served by major urban medical centers. According to the American Telemedicine Association, more than half of all U.S. hospitals now use some form of telemedicine.

According to a new study by Mayo Clinic researchers, telestroke programs are leading to lower cost. Stroke patients living in rural areas who receive care via a telestroke network experience, on average, nearly $1,500 in lower costs over their lifetime compared to stroke patients who do not receive telestroke care. The savings are primarily attributed to reduced resource utilization, including nursing home care and inpatient rehabilitation. The researchers evaluated a particular kind of telestroke care, with the healthcare provider acting as a hub that connects with a network of multiple hospitals, or spokes. They determined that when a telestroke system connects a hub with seven spokes it’s effective and cost-friendly for the patient. “This study shows that a hub-and-spoke telestroke network is not only cost-effective from the societal perspective, but it’s cost-saving,” said neurologist Bart Demaerschalk, MD, director of the Mayo Clinic Telestroke Program, and lead investigator of the study.

Thomas Hospital has been serving the communities of Baldwin County and Mobile Alabama for more than 50 years. A 150 bed hospital with a staff of more than 1300 dedicated medical professionals, Thomas Hospital has established a tradition for earning accolades for excellent service. Recently, in an effort to complement their existing neurological care department, the Hospital partnered with AcuteCare Telemedicine (ACT) and the Alabama Partnership for Telemedicine to provide virtual, 24 hour, seven days per week treatment for stroke and other neurological maladies. With its exemplary track record for providing outstanding care it is no surprise that it would seek to improve its neurological care services through the use of the latest communication technology. Dr. James M. Kiely, says “When you engage with AcuteCare Telemedicine you are engaging in more than a technical solution. You are gaining quality individuals to augment your medical staff.  Patients are able to engage with neurologists who are invested in their care.”

ACT has established itself as an innovator on the forefront of the industry, taking a unique approach to telemedicine by leveraging new technologies and techniques to enable personal neurology consultation when doctor and patient are in different locations. “The interaction between patients and families and us with the two-way, secure videoconferencing system that we have, it’s the same as being there,” says Dr. Keith A. Sanders, AcuteCare COO. “The Neurologic exam for stroke and emergency Neurology can be as safely and reliably done remotely as it is in person, I don’t think we miss anything by not being there.” With the help of ACT’s powerful and personalized services, patients throughout the ‘Stroke Belt’ states of the Southeast have drastically improved access to the care they deserve, and medical facilities increase efficiency while reducing the costs associated with maintaining a traditional emergency neurology staff. Whereas many hospitals with existing neurology departments simply do not have the resources to maintain around-the-clock clinician capacity, ACT has managed to successfully disrupt the trend and bring patient and physician together, regardless of geographical boundaries. Achieving this goal requires a certain level of investment in technology and trust in the people behind it. ACT is truly technology-agnostic.  This agility affords healthcare organizations with the ability to select the platform that meets budgetary and organizational parameters.

At Dodge County Hospital ACT partners with InTouch Health (InTouch), a leading developer and provider of remote presence devices and software, to bring remote telestroke care to its client hospitals. InTouch and ACT closely collaborate with their hospitals to easily integrate and improve the efficiency of the new remote service workflow processes as well as improve clinical performance and cost containment.  The client hospitals dedicated staff of medical professionals receive important, on-site training in the operation of the telecommunication robots and its software and form critical consultative relationships with ACT neurologist to ensure the highest quality patient care. “Having the ability to consult with a neurologist remotely for treatment of stroke and other neurological maladies is allowing these hospitals to meet the needs of the patients in the communities they serve,” says Dr. Gwynn. “We look forward to expanding our family of client partnerships throughout the region.

Hospitals all across America are finding the cost of telemedicine an affordable solution to ensuring improved accessibility of critical care and specialized treatment for their patients no matter where they live. Dr. Lisa Johnson, AcuteCare CFO, sees the healthcare environment for telemedicine as an increasingly expanding area. “Unfortunately there is an exodus of neurologists away from hospital work and on call duty. There is a particular lack of neurologists in many rural hospitals,” as the trend continues, the need for telemedicine is only going to grow, especially in the field of Neurology, where assessing an acute stroke patient can be swiftly and completely performed via remote presence.”

If your hospital or hospital system is looking to establish a stroke center to offer the best in telestroke care, AcuteCare Telemedicine, as a practice-based provider, is the best solution. For more information, please contact ACT at info@acutecaretelemedicine.com.