- Telemedicine in general, including Telestroke,
makes great sense as far as the changing healthcare picture.
We're gonna have to find cost effective strategies
to provide quality care for patients,
where they live and work.
In North Carolina, stroke is still a huge problem.
For years, North Carolina's had probably double
the national rate as far as mortality from stroke.
We're part of the stroke belt,
an area in the southeast where there's excess mortality.
We don't understand why.
The reality though is that in North Carolina,
hospitals have to take care of stroke patients,
and do it well, because there's lots of them.
The problem is that there's a mismatch
between where the patients are, who have acute stroke,
and where the facilities are that
really have a lot of stroke expertise.
That mismatch was one of the reasons
that we decided to do this.
Leveraging technology to be able
to bring access to our stroke experts,
out to those areas that don't really have access to such,
and by doing that help provide
improved access to what's potentially life saving therapies.
Planning for the Telestroke network,
actually began in late 2008.
Took a long time.
There are lots of decisions to make
when you're talking about implementing something like this.
From the technology you choose to use,
to how you setup the consults, who does them.
Many different factors.
By November of 2009, so just over three years ago now,
we signed our first contract with a hospital.
We went live with that hospital
the first week in December.
Now three years ago we've launched this,
and have steadily added additional hospitals
to our network since then.
We have the largest Telestroke network using
high quality video teleconferencing in North Carolina.
We actively work with 11 hospitals now.
10 of those are part of our formal stroke network,
and those range about 350 mile span,
from up in Jefferson, North Carolina for Ash Memorial
to Carter at General in Morehead City down on the coast.
A huge huge distance span.
We now have six vascular neurologists.
Six stroke neurologists.
That's really a unique feature
compared to many Telestroke networks around the country.
Our program, a unique aspect is that
it's really all done by our own local experts.
We provide 24/7 access to one of our vascular neurologists
here at Wake Forest Baptist Medical Center.
Now that we've been doing it three years,
we actually have some numbers
we can objectively say we think
we're accomplishing our goal.
We've probably done close to,
there's been probably about 600 activations.
We've probably done 400 consultations,
give or take a little bit.
Now, of those, if I actually beam in to see you,
and do a consultation,
then in our regional hospitals,
37% of the time, the patients are receiving TPA.
TPA is tissue plasminogen activator.
It's a thrombolytic agent, a clot busting drug, if you will.
Across the country,
of all strokes that come to the emergency rooms
only about 3% to 5% of people get TPA.
Even having said, it's an enriched sample,
because people who may be candidates,
they're asking us to see, so I understand that,
but many of the places we worked with,
the emergency rooms never even considered
or weren't comfortable giving TPA, so hardly ever did it.
We think we're actually having a huge impact
on improving the outcomes for stroke,
because we know TPA can improve
the ultimate functional outcome for patients
with ischemic stroke.
In addition, one of the goals was to have people
that were appropriate stay locally.
At the moment about 57%, I believe,
of the patients that we see in consult,
are able to remain locally.
Besides those specific outcomes in the emergency room,
it's much more than that.
The Telestroke network also has to do
with raising awareness, implementing protocols,
improving processes in those emergency rooms,
as well as education for the physicians,
for the staff, for the community.
Awareness about stroke and stroke risk factors,
and stroke warning signs.
Taken as a whole we really believe
we've had a very positive impact
on stroke care in North Carolina.