Telemedicine continues to improve the world of health care. Now, with the use of technology, people can get better access to treatment for a wide variety of conditions. One of the areas in which telemedicine has been the most successful is the diagnosis and treatment of strokes. In the U.S., strokes are the third leading cause of death, with a stroke patient dying every three minutes. Strokes happen to more than 700,000 patients every year, leaving many with permanent disabilities. Many individuals face a loss of employment or significant changes to their lifestyle. Read on for how these health care measures are helping to change how the U.S. treats strokes.
A stroke, sometimes called a “brain attack,” happens when blood flow is cut off to an area in the brain. When these brain cells are deprived of necessary oxygen and glucose, the cells end up dying. There are two types of strokes: an ischemic stroke, which occurs when clots form in the brain’s blood vessels. The clots can also form in blood vessels elsewhere in the body that then travel to the brain. These clots block blood flow. Around 80% of strokes are ischemic. The second type of stroke is hemorrhagic when a blood vessel in the brain breaks or ruptures. Blood ends up seeping into the brain tissue, which results in damage to the brain cells. This type of stroke can be the result of high blood pressure or brain aneurysms.
The symptoms of a stroke include weakness or numbness of the face, arm, or leg on one side of the body, loss of vision in one or both eyes, loss of speech, difficulty talking or understanding other people, sudden severe headaches, or loss of balance or unstable walking. If stroke patients don’t receive an immediate diagnosis and treatment, there could be permanent brain damage. In more serious cases, death of the patient can occur. Therefore, time is the most important aspect of treatment – the sooner a patient is diagnosed and treated, the better their prognosis will be. Some patients can stave off disabilities caused by strokes if they are given the FDA-approved medication tPA (tissue plasminogen activator) within the first three hours of the stroke occurring.
Thanks to telemedicine, stroke patients are receiving faster, more effective diagnosis and treatment.
Telemedicine is changing the treatment of strokes by implementing programs called telestroke. These programs are run by doctors (usually neurologists) who are able to remotely evaluate stroke victims through digital video cameras, web communications, and robotic telepresence. These doctors work to quickly diagnose the stroke patient and come up with a treatment plan that can best serve the individual – all without needing to physically examine the patient. The telestroke system generally has three elements to it: a brain imaging review, a remote examination, and a web portal for synchronized requirements. Doctors can download and view brain scans from any location to help determine the best course of action for a particular patient. The remote examination is done with video conferencing, where physicians can perform the evaluations to determine the cause and severity of the stroke. This allows them to come up with a diagnosis and treatment plan that can be transferred to whichever hospital or facility the patient is taken to. All of this data obtained from the telestroke program is available through a web portal that lets a team of doctors share valuable information about the patient.
In an interview with Medscape, Dr. Lawrence R. Wechsler, chairman of the American Heart Association and American Stroke Association, stated that some of the telestroke systems “have CT scans in the ambulance and can give tPA right there and then. Others just use an iPad in the ambulance to connect to the stroke expert.”
One of the biggest ways telestroke can help patients is by assisting individuals who live in remote areas. A recent study estimates that three out of every four counties in the U.S. lack a nearby hospital that has the neurological services needed to effectively treat stroke patients. Telemedicine can therefore provide the very best neurologists on hand to stroke patients – no matter where they live. Thus, people living in rural areas can still access the very best health care options and are much more likely to have a strong chance of recovery.
Advances in stroke diagnosis and care are just one of the myriad benefits of telemedicine.
There’s a growing amount of evidence that demonstrates telestroke measures have been effective in treating stroke patients. Back in 2016, Kaiser Permanente released a study showing that of more than 2,500 people diagnosed with ischemic strokes, there was an almost 75% increase in the timely use of the drug tPA after the patients received a telestroke consult. With telestroke care, patients were also able to get a diagnostic imaging test 12 minutes sooner, while drugs were administered 11 minutes sooner, reducing overall initial treatment times to less than an hour. The study noted, “Particularly in hospitals with limited resources and/or limited access to neurologic expertise, telestroke is an important tool to aid in the evaluation and treatment of potential stroke… Telestroke may aid in triage and transfer decisions and in identifying patients potentially eligible for endovascular intervention or patients who might otherwise benefit from transfer to a stroke center.”
Bottom line: telestroke programs allow stroke patients to have quicker and more in-depth evaluations that can be truly life-saving. Without telestroke measures, many patients would face waiting longer periods of time between the stroke event and making it to the hospital where they can meet with a physician. With instant diagnostic tests and communication with physicians, stroke patients have a much better shot at making a full recovery because of these vital telestroke programs.