Innovative Telestroke Technology Improves Care and Reduces Costs
According to a new study presented today at the Canadian Stroke Congress, the use of long-distance video and data hook-ups to link remote community hospitals with stroke neurologists in large centres provides the same level of care as having everyone in the same room.
The study found that rural patients examined with the aid of Telestroke received the stroke drug, tPA, at the same rate as patients treated in specialized urban centres.
The drug, tPA (tissue plasminogen activator), is used to break up blood clots. It can help to reverse stroke damage if administered within 4.5 hours of the onset.
Dr. Jeerakathil, one of the neurologists at the University of Alberta Hospital, commented that besides providing better care to remote communities, early projections show that Telestroke resulted in more than $1 million in healthcare savings over four years.
“Telestroke is a way to bring the expert out to the rural centre to provide treatment that wouldn’t otherwise be available,” Dr. Jeerakathil added. This means that “there is no delay in treatment despite the time required to set up video conferencing equipment and examine CT scans and blood work.”
In the study, which was an initiative of the Alberta Provincial Stroke Strategy, University of Alberta Hospital neurologists observed the use of Telestroke in 10 primary stroke centres throughout remote parts of Northern Alberta over a four-year period.
During this time, tPA was administered to more than 500 people and, of those, 119 patients were treated with the help of Telestroke. Without access to the technology, these patients would have gone without treatment or been transferred to a bigger hospital and faced delays, Dr. Jeerakathil noted.
Effective Telestroke treatment in remote areas contributed to a 50% decrease in emergency room transfers from rural areas to the University Hospital in Edmonton, said Dr. Jeerakathil. Some remote hospitals reported a decrease in transfers as high as 92%.
Telestroke allows small hospitals to be designated as primary stroke centres with many of the services of a major stroke unit. These primary stroke centres have a small sectioned off area with staff specially trained in stroke care, 24-hour access to a CT scan and the ability to give tPA.
“Telestroke is severely under-utilized in Canada,” says Dr. Antoine Hakim, CEO and Scientific Director of the Canadian Stroke Network. An audit of stroke care in Canada showed that less than 1 per cent of stroke patients received a Telestroke consultation. “This study undeniably proves that Telestroke saves both lives and money.”
“Providing stroke patients fast and seamless access to stroke services regardless of where one lives in Canada will save lives and reduce disability,” observed Dr. Michael Hill, spokesperson for the Heart and Stroke Foundation. “Telestroke is another way that technology allows for an easy, cost-effective way to bridge geographic barriers to smoothly link stroke specialists with communities where on- site stroke care does not exist.”
There are roughly 50,000 new strokes in Canada each year and 315,000 Canadians living with the after-effects of a stroke.