Stroke Telemedicine

Stroke Telemedicine: Using Technology to Bring Our Experts into Community Hospitals

A patient comes into the emergency department (ED) of a community hospital at midnight. The patient’s symptoms suggest ischemic stroke, but the ED physician would like a neurology consult to confirm the diagnosis and suggest a treatment plan. Thanks to a new telemedicine program at MedStar Washington Hospital Center, the community ED physician will be able to consult face-to-face with a Hospital Center stroke specialist using the InTouch® telemedicine system.

The InTouch telemedicine system gives patients and community physicians immediate access to stroke specialists. With time to treatment being such a critical factor in determining how well a patient recovers from a stroke, telemedicine consultation will play a significant role in saving lives and improving patient outcomes.

The Hospital Center’s stroke team neurologists are available around the clock. As the telemedicine program expands into community hospitals, physicians at other locations will be able to consult with the Hospital Center’s team of experts. Each of the Hospital Center’s stroke team attendings has a telemedicine-enabled laptop, with Webcam and headset. At participating community hospitals, physicians and patients will be stationed next to a telemedicine cart. Attached to the cart is a large monitor, through which the physician will see and speak to the Hospital Center’s stroke specialist, as well as send lab findings and imaging results. The patient and family can also talk face-to-face with the Hospital Center stroke specialist, who is able to remotely perform a neurological exam on the patient and view the brain images directly, rather than relying solely on a verbal description of the findings.

MedStar Health’s Montgomery General Hospital will be one of the first hospitals linked to the stroke service. Roger Leonard, MD, vice president of Medical Affairs at Montgomery General, says his patients will benefit from the stroke telemedicine program. “This elevates Montgomery General’s accredited program to include rapid access with the comprehensive stroke program at the Hospital Center. It includes an enhanced availability to stroke experts and to interventional therapies 24/7.” He adds, “The collaboration between our ED physicians and the Stroke Center’s neurologists permits consensus, optimal care and facilitates rapid transfer when deemed appropriate.”

Amie Hsia, MD, is medical director of the Washington Hospital Center Stroke Center. “The video quality of this system is so good, we can zoom in and see the patient’s pupils constrict or dilate,” Dr. Hsia says. “The two-way video enables us to discuss treatment options with patients and families as if we were standing at the bedside.” When t-PA is indicated, the ED physician in the outlying hospital administers the t-PA, and the patient may then be transported to the Hospital Center for further management. Also, because of the Stroke Center’s affiliation with the National Institutes of Health, the Hospital Center offers patients access to clinical trials for stroke care. “We expect this program will improve communication with outlying hospitals, expedite appropriate treatment for patients and enable us to offer more patients the opportunity to participate in clinical trials,” Dr. Hsia says.