AcuteCare Telemedicine Blog


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.



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.



Major Advance in Chronic Stroke Treatment

For those who dedicate their professional careers to providing medical care to patients suffering from persistent and chronic disease, treatments that reduce disability and save lives do not come along often enough. And when they do come along, promising new technology and treatments all too often do not deliver on their initial promises after being subjected to critical clinical trials. But stroke experts are reporting a major advance in the treatment of chronic stroke which, after numerous clinic studies and trials, appears to be living up to the initial promises.

Stents similar to the ones used to open clogged heart arteries can now be used to clear a blood clot in the brain, greatly lowering the risk a patient will end up disabled. Most of the 800,000 strokes in the U.S. each year are caused by a blood clot lodged in the brain. Now an Endovascular device, a metal mesh cage called stent, can be inserted thorough a blocked blood vessel to more quickly retrieve and remove a clog. At a recent American Heart Association (AHA) International Stroke Conference in Nashville, TN doctors reported that patients treated with these brain stents were far more likely to be alive and able to live independently three months after their stroke. The treatment was so successful that three studies testing it were stopped early, so it could be offered to more patients. One study also found the death rate was cut almost in half for those given the treatment.

“This is a once-in-a-generation advance in stroke care,” said the head of one study, Dr. Jeffrey Saver, stroke chief at the University of California, Los Angeles. Early endovascular clot removal is improving stroke outcomes beyond those patients who received treatment with thrombolytics alone. “This is a real breakthrough,” agreed Patrick Lyden, MD, director of the stroke program at Cedars-Sinai in Los Angeles, “There’ve been very few people as critical as me about this procedure, but even I have to take a look at the data and say we have to believe this.”

The results shown from the three trials is a major verification of the treatments previously promised benefits. An independent expert, Dr. Lee Schwamm of Massachusetts General Hospital, called it “a real turning point in the field.” For those many patients who can be offered this treatment, “This is the difference between returning home and not returning home.”

The procedure could be offered to patients regardless of whether they’re a candidate for clot-dissolving medicine called tissue plasminogen activator (tPA), but the evidence supports the patient getting both treatments if eligible. Stroke care “needs to be completely changed” to make the treatment more widely available, said Dr. Walter Koroshetz, acting director of the National Institute of Neurological Disorders and Stroke. “This has taken stroke therapy to the same place that heart attack therapy is now,” he said.

Stent treatment of stroke has a narrow time window for use and is less effective for those who seek help too late. The key to surviving a stroke is recognizing the warning signs including; numbness or weakness on one side, confusion or trouble speaking, visual changes, and trouble walking, and then getting help within three to four hours after the onset of any of these symptoms.



Telemedicine is Providing Improved Access to Neurological Care

Before the introduction of telemedicine, small to medium sized rural hospitals often played the role of stabilize and transport centers, a brief stop-over for patients needing specialized treatment and care. Patients would receive treatment to stabilize their condition, were packed-up and then transported to urban healthcare centers where specialist were standing-by to administer much needed specialized treatment.

The process often results in delay for patients receiving important, often life-saving, treatment, inconvenience and increased costs. “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 and AcuteCare Telemedicine CEO.   The merging of telemedicine with neurology is changing the “stabilize, pack and ship” role of smaller hospitals and is bringing life-saving neurological and advanced stroke care to their patients within their own communities.

AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care is continuing to expand their portfolio of client hospitals with the recent addition of Dodge County Hospital. Located in Eastman, GA, the 94 bed healthcare facility is a Hospital Corporation of America (HCA) affiliate that is dedicated to meeting the challenges of a changing healthcare environment.

Dodge County Hospital is a prime example of how telemedicine is helping smaller regional medical facilities achieve their mission of delivering the highest quality healthcare services to their patients and their communities. “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.

ACT partners with InTouch Health (InTouch), a leading developer and provider of remote presence devices and software, to bring remote telemedical 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.

Smaller 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. James Kiely Honored To Be Entrusted With Offering Guidance And Care

Dr. James M. Kiely characterizes his AcuteCare Telemedicine team as personable, professional, expert, engaged, and available.

“People feel they are buying hardware when they engage in telemedicine,” says the neurologist originally from Peoria, Ill., and raised in Naples, Fla. Dr. Kiely has been named one of America’s top doctors by U.S. News and World Report in recent years. “They think that (telemedicine) is just an app and they are gonna have this faceless, personless, characterless interaction. When you engage with AcuteCare Telemedicine you are engaging in a staffing solution,” Dr. Kiely adds. “You are gaining quality individuals to join your medical staff and your patients are going to be engaging with individuals with whom they can relate on a personal level who are invested in their care.”

Dr. Kiely’s own investment in medical care took flight after graduating with honors from the University of Florida. He still follows his beloved Gators. He received his M.D. from Emory University and Ph.D. from the Emory Department of Pharmacology. He completed his neurology residency at the University of Virginia and has been a partner of Atlanta Neurology since 2000.  In 2009, he became a founding member of AcuteCare Telemedcine.

It is the duality of the mind and brain that drew Dr. Kiely to neurology. “The idea that this was at once an organ and at the same time it is where we manifest ourselves,” the father of four says. “There is no disease that affects the brain without affecting who that person is,” he adds. “It affects their actual sense of self.”

AcuteCare Telemedicine was created, Dr. Kiely says, to guide and significantly impact the well-being of patients with a sudden catastrophic event who otherwise wouldn’t have swift access to vital expertise.

Dr. Kiely is pleased at telemedicine’s high level of patient and family acceptance. “To be able to come in and affect somebody in this way at the time of their most crucial need is undeniably a very personal experience for the patient and the physician,” he says. “Using technology you can still go to the bedside and look around the room. It really is a very personal encounter and I have yet to have a patient or family, when asked, say they’d rather not be treated this way.”

The doctor’s Irish Catholic descent drives him to go to work, do his job, and share his talent. He derives inspiration from patients and their caregivers. “Faced with life-changing, even life-ending circumstances they make difficult decisions and endure daily challenges I have never personally had to,” Dr. Kiely says. “It is an honor to be trusted with providing counsel and guidance.”

Examples of the life-saving impact of telemedicine come easily from Dr. Kiely. He tells of a call suggesting a patient was exhibiting stroke symptoms. The ER physician sought advice regarding treatment with tPA, the clotbusting stroke drug. But when Dr. Kiely went online, it turned out to be something else. “Once I ‘beamed in,’ spent time in the room with the patient and had a conversation with his wife, it became apparent that he needed an acute, urgent intervention for stopping seizure, not for treating a stroke,” he says. The patient was having subtle seizures that mimicked the appearance of a stroke.

Amid the technology that enables telemedicine, the concept revives a method of care from days gone by, when doctors actually made housecalls.

“Everything old is new again,” Dr. Kiely says. “It wasn’t until after World War II and an increase in specialists and hospitals, that patients were brought to the doctors. We’re still using doctors’ offices and hospitals as a setting for care, but it won’t be long before patients routinely see physicians in their offices and homes. You may keep a child home from school, and have the physician see the child there or at the school.”

When Dr. Kiely isn’t making long-distance housecalls, he enjoys exercising, movies and hanging out with family and his wife of 27 years. He misses having the time to relax with brewing and gardening.

Fishing is not among his off-hours hobbies, but is his analogy for his work at AcuteCare. He doesn’t need fishing, stating he gets enough hours of contemplation interspersed with minutes of intense action at work. “You are gonna go out there. You have no idea what your day may hold, but you know it’s gonna be worthwhile,” Dr. Kiely reflects, connecting hook and line, with his healthcare duties. “It’s gonna be exciting. You’re gonna make a difference. You’re gonna have some fun. There is nothing routine about it.”



Telemedicine Increases tPA Use for Stroke Treatment

Presented at the annual American Academy of Neurology meeting in early May, a new study highlights the benefit of teleneurology care. The report indicates that a telemedicine program for patients with acute ischemic stroke increases the use of recombinant tissue plasminogen activator by as much as 13% in the year after the program’s implementation.

Stroke patients who receive the clot-busting drug tPA within 60 minutes of experiencing stroke symptoms have the best chance of avoiding brain damage or death. The administration of intravenous recombinant tissue-type plasminogen activator (tPA) and intra-arterial approaches, attempt to establish revascularization so that cells in the penumbra can be rescued before irreversible injury occurs, but restoring blood flow can mitigate the effects of ischemia only if performed quickly. “Most of the 13 hospitals in the study significantly increased their recombinant tissue plasminogen activator (tPA) use”, Dr. Jeffrey C. Wagner said at the annual meeting of the American Academy of Neurology.

The study population included patients aged 18 years and older who were admitted with a primary diagnosis of acute ischemic stroke. The hospitals represented a variety of patient demographics. About two-thirds were rural; approximately half were small, defined as fewer than 200 beds. The hospitals were located in the Northeastern, Southern, and Western portions of the United States.

Overall, tPA administration increased significantly, from 4.5% to 7.3% after a telemedicine program was introduced and the use of tPA in smaller hospitals increased from 1% to 7% after implementing a telemedicine program, compared with an increase from 5.4% to 7% in larger hospitals. Those results were similar when patients were stratified as inpatients or transferred patients.

The benefits of intravenous tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS) are time dependent and guidelines recommend a door-to-needle (DTN) time of 60 minutes or less. However, studies have found that less than 30% of US patients are treated within this time window. Target: Stroke was designed as a national quality improvement initiative to improve DTN times for tPA administration in patients with AIS. Implementation of a national quality improvement initiative was associated with improved timeliness of tPA administration following AIS on a national scale, and this improvement was associated with lower in-hospital mortality and intracranial hemorrhage, along with an increase in the percentage of patients discharged home.

“Reducing DTN time is a primary goal when treating patients via telemedicine”, says Keith A. Sanders, Founder and Director of the Stroke Center of Emory St. Joseph’s Hospital and AcuteCare Telemedicine (ACT) COO. “ACT has seen dramatic improvements in the tPA administration rate and DTN times at our hospitals. We collect, review and distribute DTN times and other quality measures to our hospital partners. This report reaffirms the importance in administering tPA and its impact on patient outcomes.”



Recognizing the Symptoms of Stroke

While stroke awareness is a major concern for both men and women, a recent study concluded that women are less likely to recognize stroke symptoms. Only half of those surveyed know that sudden weakness or numbness on one side of the face, arms or legs is a warning sign of a stroke. 44 percent are aware that speech difficulty is a stroke sign while less than 1-in-4 could identify sudden severe headache, unexplained dizziness and sudden vision loss, or vision loss in one eye as the top symptoms of stroke. The study surveyed more than 1,200 women in the United States to assess their understanding of stroke’s warning signs.

The signs and symptoms of a stroke vary from person to person but usually begin suddenly. As different parts of the brain control different parts of the body, your symptoms depend upon the part of the brain affected and the extent of the damage.

The main stroke symptoms can be remembered with the word F.A.S.T.: Face-Arms-Speech-Time.

  • Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
  • Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
  • Speech – speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
  • Time – it is time to dial 911 immediately if any of these signs or symptoms at the earliest onset of these symptoms

For those living with or who care for somebody in a high-risk group, such as someone who is elderly or has diabetes or high blood pressure, being aware of the symptoms is even more important.

The acronym “FAST” is also meant to underscore the importance of rapidly delivering treatment to stroke patients. If given in time, a clot-busting drug administered during a stroke can lead to better outcomes and a decrease in the likelihood that a patient will suffer long-term disability. A recent study examined the effectiveness of tissue plasminogen activator (tPA) relative to the delay in administering this clot busting drug. Researchers found that every minute tPA was delayed cost nearly 2 days of disability free survival. The researchers commented that their message is literally “Save a Minute, Save a Day.”

Although many Americans live relatively close to a hospital where emergency stroke treatment is available, few actually receive the recommended therapies. Researchers found that only 4 percent of the more than 370,000 Medicare patients who suffered a stroke in 2011 were treated with tPA. Most stroke victims fail to recognize the symptoms of stroke or call 911 early enough to receive the necessary treatment. tPA is most effective when administered within a 4 hour window of time.

Every minute counts for stroke patients. Remember to act F.A.S.T.!



Taking It to the Patient

Gadget and device gurus are working hard to fill the need for advanced tools to help medical care providers in the field bring the best medical care to the patient even in the remotest corners of the world.  Remote Diagnostic Technologies (RDT) in the UK, with funding from ESA’s Advanced Research in Telecommunications Systems Program has developed a robust portable device for monitoring vital signs and providing communications for medics in the field. The Tempus Pro combines the diagnostic facilities found in standard hospital vital signs monitors with extensive two-way communications, packaged in a compact, rugged, highly portable unit that can be tailored to user needs. The key to the unit’s success is that it is a fully functional, hospital-grade vital signs monitor and takes less than an hour for an experienced medical professional to learn the basic functions.

In the United States, a University of Virginia Health System (UVA) team is working with local rescue squads to diagnose stroke patients before they reach the hospital, enabling more patients to receive lifesaving treatment and have a full recovery. UVA clinicians are raising $10,000 to equip two additional local ambulances with the iTREAT mobile telemedicine kit. The goal: Connect paramedics through a secure video link with UVA’s specially trained stroke neurologists and emergency medicine physicians, who can diagnose stroke patients while they’re in the ambulance and enable treatment to begin as soon as patients arrive at the hospital. Fast diagnosis and treatment is vital because the most effective treatment for acute ischemic stroke patients — the clot-busting drug tPA — is only safe and effective if delivered within three hours of when symptoms begin. Due to delays in reaching a hospital and receiving a diagnosis, less than 5 percent of all stroke patients receive tPA. Promising faster care for a variety of patients and treatments, The iTREAT technology is in the testing stage with local rescue squads, with the hope of using it to care for Central Virginia patients in early 2014.

A debate as to what or who spawned the revolution in using communication technology to advance a new medical care delivery model, the need or the gadget, is unimportant.  Teaming the hospital based life-savers and their dedicated field associates with savvy techies is creating an environment where patients are receiving better and faster advanced life support no matter where they are located. Telemedicine is taking to the patient!



Expanding tPA Stroke Treatment Through Telestroke Delivery Model

For years, the mantra of neurologists treating stroke victims has been “time equals brain.” That’s because getting a patient to the emergency room quickly to receive a drug that dissolves the stroke-causing blood clot can make a significant difference in how much brain tissue is saved or lost. Established research has demonstrated that administering a tissue plasminogen activator (tPA) intravenously up to 4.5 hours, after the onset of a stroke, benefits patients with moderate to severe acute ischemic stroke. An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain and it accounts for 87 percent of all stroke cases.

While the use of tPA significantly improves a patients recovery from stroke its administration requires the availability of neurologic expertise within this narrow window of time.  Specialized stroke care at large academic medical facilities is very effective in providing stroke care but access to these centers is limited to patients living in rural areas of the country.  Practiced-based telestroke services, staffed primarily by general neurologist, offer a streamlined organization that facilitates the dissemination of this vital emergency treatment but a comparative analysis of the data between the two delivery systems is a critical.

“Expanding Access to Intravenous Tissue-type Plasminogen Activator with a Practiced-based Telestroke System” was recently published by the Journal of Stroke and Cerebrovascular Diseases.  The study was prepared by 4 practiced-based neurologists at AcuteCare Telemedicine (ACT), an Atlanta-based company that’s billed as the largest practice-based provider of teleneurology in the southeast.  Summary findings included data gathered over a two year period at 7 hospitals on 202 emergency telemedicine consultations and treatment of 54 telestroke patients with IV tPA.  Patient demographics and outcome measures were not significantly different for patients treated by practiced–based or academic providers with the exception of lower age and shorter stay duration of the practiced-based treatment group.

The results indicate that emergency stroke care provided by the two delivery models can achieve similar patient outcomes and that a practiced-based telestroke system can expand the availability of IV tPA treatment with clinical outcomes no different from previously published studies.

“Meeting the requirement of providing rapid neurology care to all of the nation’s emergency rooms will necessitate a concerted effort of academic and practiced-based stroke systems”, said Dr. Keith A Sanders, ACT.  The technological, organizational and financial hurdles which currently limit telestroke use and expansion will likely be resolved as the benefits of telemedicine become more evident with its expanded use.

For more study details and the full article, contact info@acutecaretelemed.com



Positive Patient Outcome Advances the Telemedicine Delivery Model

Recently a team of researchers from UCLA completed a major study on the use of tissue plasminogen activator, or tPA, on stroke victims within 4.5 hours after the stroke occurs. That study of more than 50,000 stroke patients, as reported in a recent issue of JAMA, The Journal of the American Medical Association, confirms that the sooner tPA is administered, the better chance of recovery.  In response to the study, AcuteCare Telemedicine (ACT), an Atlanta-based company that’s billed as the largest practice-based provider of teleneurology is making an aggressive push to help smaller hospitals and networks that don’t have immediate access to neurologists.

Their efforts have proven to be life saving for one Ozark, Alabama resident and recent stroke victim.  The collaboration between ACT and the Southeast Alabama Medical Center (SAMC) is having its desired effect for SAMC patients, providing once unavailable, advanced life saving treatments to stroke patients. The Stroke Care Network, established in Dothan, Ala., in collaboration with ACT, the Southeastern Alabama Medical Center Foundation and the Alabama Partnership for Telehealth provides stroke services for a 240-square-mile swath that includes southeast Alabama, southwest Georgia and the Florida Panhandle.

The collaboration was initiated when Cecilia Land, SAMC’s division director for rehabilitation services discovered an increase in the areas mortality and morbidity due to stroke. “We recognized an immediate need to establish a stroke care network, providing patients with access to 24×7 teleneurology,” said Land.  SAMC officials hope to add more “spokes” to the network, in the form of hospitals and clinics, and also want to use the network to educate communities on the importance of wellness and identifying precursors to a stroke.  Dr. Keith A. Sanders from AcuteCare Telemedicine hopes to extend ACT’s telemedicine platform to other specialties, such as telepsychology, and he expects more hospitals and health networks will buy into the system as executives see the benefits of sharing specialist services without having to house them on-site.

This most recent life-saving patient outcome from the collaboration between ACT and SAMC is proof that the new telemedicine health care model is an excellent vehicle to advancing the availability and quality of telestroke care to SAMC patients and to underserved patients all around the country.