The Michigan Stroke Network is using telemedicine to facilitate rapid stroke treatment in emergency departments and improve patient transfers to stroke centers where they get comprehensive treatment.
Problem: Stroke is the 3rd leading cause of death and a leading cause of long-term disability, and recovery depends on prompt response with the appropriate treatment. However many hospitals do not have access to stroke specialists to make live-saving and function-saving decisions when seconds count.
Innovative Program: In 2006, The Michigan Stroke Network started using robotic technology to provide 24-hour access to stroke specialists for 31 participating hospital emergency departments. Specialists can guide the treatment as thought they were present at the patient's bedside.
How it Works: When a patient with signs of stroke arrives at a participating hospital ER, the hospital calls a toll-free number that pages the oncall stroke specialist who logs onto a laptop using a wireless Internet connection. The specialist "virtually arrives" within 9 to 12 minutes and uses a joystick to move the 5-ft robot and it's camera to observe the patient, view and assess lab results, CT scans and other diagnostic tests conducted by the ER, and make treatment recommendations. If the patient requires transfer to a stroke center, a helicopter crew (that was also alerted with the initial page) is onsite within minutes.
Ongoing Stroke Education: Ongoing education for medical professionals allows review of protocols and assessment processes to improve response time. Robots are also used to educate the public about stroke symptoms and prevention via virtual health fairs.
Results: In the first 17 months, the on-demand remote consultations have enhanced care for 173 patients at 31 participating hospitals. Patients received life-saving therapies (such as rt-PA) in more than 70% of cases.
Additional Observations: Access to stroke specialists is a significant challenge for many hospitals. The decision to start certain therapies that can save lives and restore function is dependent on specialized expertise -- if the therapy is given under the appropriate circumstances, patients have a much better recovery record. But if given in the wrong circumstances, the therapy can cause death or futher damage. These decisions are not usually made by the ER physician, but depend on highly specialized expert consultation that is most often not immediately available.
This robotic technology that allows two-way audio and visual communication between the specialist and the patient results in dramatic improvement in assuring that patients who meet the right criteria get life-saving treatment when it's needed.
For more information, see
http://www.innovations.ahrq.gov/content.aspx?id=1789
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Hi Sheri,
ReplyDeleteI think technology is terrific, but it is even better when technology is used to save lives. Thank you for the post. Kathy
Sheri,
ReplyDeleteBoth my mother and my husband's mother have had TIA's in the past 10 years so I have tried to educate myself about stroke prevention, and treatment. I understand about the window of time during which a stroke victim must receive treatment to minimize damage. The use of telemedicine and telepresence of medical professionals and "robots" would appear to address the need for increased efficiency of medical attention for stroke victims. I'm looking forward to seeing further developments in this medical area in the next decade.
Diane
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