Abstract W P365: Incorporating Telemedicine Access for Stroke in Vulnerable Alaskan Populations
Background and Purpose: The State of Alaska covers a vast area the size of California, Texas and Montana combined and comprises one-fifth of the total U.S. land mass. The population of approximately 735,132 is spread over 362 communities. The Alaska Native populations comprise 14.7% of the total population of Alaska with most of its members living in remote villages or isolated islands. Two hundred Alaskan communities can be reached only by boat or air. Public health and preventative services are challenging due to inaccessibility during winter months, high winds, volcanic activity, and poor infrastructure. The introduction of telemedicine to critical access facilities has proven effective for not only emergent delivery of stroke interventions but looks to promote access in the primary health setting as well. The purpose of this project was to identify barriers to neurological health and risk factors unique to Alaskans.
Methods: Guided by a telehealth model of care for emergency Stroke cases, Providence Alaska Medical Center increased access to 5 spoke hospital sites in the Southeast portion of the State in the past six years. As the hub site for the State, Alaskans are placed in a national data base for outcomes, modifiable risk factor management and disability measurement. Interdisciplinary debriefings occur monthly for evidence-based practice agreements.
Results: Patients have access to the only Cerebrovascular Neurologist in the State with a 50% increase in the delivery of tPA for ischemic stroke. Improved door-to-needle times, increased tPA delivery and interventional radiology, along with a decrease in length of stay has lead the way to developing a more extensive telestroke network within the Providence system.
Conclusions: Access to primary and emergency neurological care remains a barrier to many Alaskans, especially those living in remote and isolated areas of the State. Using ongoing statistical data compared to other national averages, the telemedicine method of stroke care has proven vital to reducing morbidity and mortality in its large geographical boundaries. Further attention to a telestroke program will only enhance outcomes in the future.
Author Disclosures: D. Lada: None. J. McGraw: None. R.A. Lada: None.
- © 2015 by American Heart Association, Inc.