AcuteCare Telemedicine Blog


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.



Telestroke Is Proving to Be a Saver

Telestroke programs have been proving themselves very effective in bringing critical care to patients in rural areas throughout the country for a few years now and testimonials about patients who have benefitted from advanced, specialized treatment via telemedicine technology are becoming more common place. Receiving advanced stroke care faster is saving lives and resulting in less debilitating recoveries. Telemedicine programs help extend higher quality care to patients living in more rural areas, but some have questioned whether the cost to implement and maintain the technology and services has been thoroughly vetted and considered.

According to a new study by Mayo Clinic researchers, a telestroke program is leading to lower cost. Stroke patients living in rural areas who receive care via a telestroke network see, on average, nearly $1,500 in lower costs over their lifetime compared to stroke patients who do not receive telestroke care, researchers found. The savings are primarily attributed to reduced resource utilization, including nursing home care and inpatient rehabilitation. Researchers also estimate that, compared with no network, a modeled telestroke system consisting of a single hub and seven spoke hospitals may result in the appropriate use of more clot-busting drugs, more catheter based interventional procedures and other stroke therapies, with more stroke patients discharged home independently.

Despite the considerable upfront and maintenance expenses, the entire network of hospitals realizes a greater total cost savings, officials say. “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, in a press statement. “We can assess medical services, like telemedicine, in terms of the net costs to society for each year of life gained.”

“The results serve to inform government organizations, insurers, healthcare institutions, practitioners, patients and the general public that an upfront investment in telemedicine and stroke network personnel can be justified in our health system,” added Demaerschalk.

Today there are 10 million people utilizing telemedicine and the number will continue to rise as more state legislatures and medical insurance providers realize the benefits to providing payment and reimbursements for telestroke and telehealth services.