January 22, 2018 |
TeleStroke Center Provides Real-time Resources for Better Patient Care
July 23, 2013  | 

Boston, MA - At 9:50 PM, a man relaxing at home has a sudden, severe headache, and starts to slur his words. At 9:53 PM, his wife calls 911. At 10:13 PM, the ambulance arrives, and by 10:19, they are en route to their regional community hospital, 20 minutes away. At 10:42 PM, the patient is wheeled into the emergency department. The ED team rapidly determines that stroke is likely. At 10:55 PM, they send the patient for a CT scan. Then they call the MGH TeleStroke Center. Time is brain.

“There has been a fundamental transformation in the way intravenous tPA is delivered in this country,” according to Lee H. Schwamm, MD, Director of TeleStroke and Stroke Services at Massachusetts General Hospital. He’s talking about tissue plasminogen activator, the thrombolytic agent that has become the standard of care for ischemic stroke. “We now give almost three times as much tPA over our TeleStroke network as we do for patients arriving at the doors of MGH.”

At 11:02 PM, the ED doctor is in a video conference with the MGH stroke specialist. Together they perform a brief neurologic exam on the patient. The patient’s medical history and current medications are uploaded and the team discusses their implications. At 11:12 PM, the stroke specialist receives the brain image files, and begins to evaluate them.

Through the TeleStroke network, 30 emergency departments across the northeast have real-time access to stroke experts 24 hours a day, seven days a week. The videoconferencing system, which Dr. Schwamm describes as “Skype on steroids,” brings the expertise of the MGH staff into the emergency room whenever and wherever it is needed. “We are probably the largest continuously run academic TeleStroke center in the country, probably the world,” he says. Continue>

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