Abstract 3997: Maintainence of Stroke Certification with Telemedicine
Introduction: In May of 2010 Mayo Clinic Florida (MCF) partnered with Parrish Medical Center (PMC) in Titusville, Florida to provide remote evaluation and treatment of acute ischemic stroke patients and triage of patients for urgent transfer. PMC was initially accredited as a Joint Commission Primary Stroke Center in 2003. In the 12-month period prior to the telemedicine partnership acute neurology coverage was not continuously available, and the rt-PA utilization rate was 0.8%.
Methods: Demographic data, baseline stroke severity, time of symptom onset, telemedicine diagnosis, rt-PA utilization, complications, discharge stroke severity and discharge disposition were collected prospectively. Analysis was also performed on the success of the administrative effort, including sharing of patient and statistical information, credentialing, faculty cooperation and patient satisfaction.
Results: During the first 15 months of the partnership, 193 robotic telemedicine consultations were performed. The mean time from consultation request to telephone response was 3 minutes. 86 patients had a telemedicine diagnosis of stroke and 18 (21%) patients were treated with intravenous rt-PA within 3 hours of stroke onset. Among those treated with iv rt-PA, the mean time from telemedicine evaluation to rt-PA treatment was 54 minutes. The sICH rate was 0%. The median baseline NIHSS was 8.5; the median discharge NIHSS was 2. 18 patients were urgently transferred for consideration of endovascular/surgical stroke therapies. PMC was re-certified as a primary stroke center since by the joint commission in May of 2011 with no deficiencies.
Conclusions: These data confirm that telemedicine can identify patients eligible for local treatment with intravenous thrombolysis or those who would benefit from urgent transfer to a comprehensive stroke center. Telemedicine can deliver stroke care at the benchmark levels required to maintain primary stroke center certification.
- © 2012 by American Heart Association, Inc.