When it comes to treating stroke, every moment counts. A stroke patient only has a three-hour window from symptom onset in which access to the clot-busting and lifesaving drug tPA can do the most good; after that, the chances of recovery plummet. Unfortunately, many regional and rural hospitals don’t have a 24-hour neurologist on hand to make timely diagnoses. To make things worse, only about 27 percent of stroke patients arrive at the hospital within 3.5 hours of symptom onset, leaving nearly three-quarters of stroke patients at risk for more permanent damage. (1) In an effort to deliver care to patients in a timelier manner, systems are increasingly looking into mobile telestroke programs.
Mobile telestroke technology combines real-time video telemedicine transmissions from the field with on-call neurologists at stroke centers. Now, instead of meeting a neurologist upon arrival at the hospital, a potential stroke patient’s assessment can begin before they are even in the ambulance.
One approach is to create an all-in-one Mobile Stroke Unit with a head CT scanner onboard and a video link to neurologists who can read the scan results and order treatment en route. swyMed’s software delivers the video connections on almost half of the early adopters of this approach.
A second approach is to add the video link, but not the CT scanner to ambulances. As the Mobile CT is an expensive piece of technology, more ambulances can be video enabled. The video and communications link enable remote neurologists to review cases while en route to the facility. If diagnosed with a stroke, the CT scanner can be readied and the patient can go straight to CT and tPA treatment where appropriate, bypassing the emergency department completely. This option shaves minutes from the time of symptom onset to time of treatment.
Regardless of the approach taken, to be truly mobile, a telestroke initiative must be able to consistently and reliably deliver a high-quality, telemedicine connection to a physician in real time. Rural areas, with few cell towers, often lack the consistent connections, and even urban areas, with their plentiful cell towers, can have dead spots. There has to be a better way.
swyMed’s DOT Telemedicine Backpack makes mobile telestroke possible through a combination of software, hardware and services designed to work in concert to allow exceptional quality video encounters, and unparalleled availability, even in the most difficult environments. The DOT allows ambulances to reliably connect—and stay connected—with neurologists while traveling to the hospital, saving time, money, and ultimately improving the outcomes of stroke victims.
1.) Tong D, et al. Times from symptom onset to hospital arrival in the Get With The Guidelines-Stroke Program 2002 to 2009: temporal trends and implications. Stroke. 2012;43:1912-1917.