November 15, 2007 - On Oct. 22 the Swedish Neuroscience Institute became the first hospital in western Washington to activate an advanced telemedicine system in the emergency rooms of its Issaquah and Ballard campuses to provide a real-time, 24/7 link between ER physicians and stroke specialists based at the Cherry Hill Campus, where Swedish’s nationally recognized stroke program is based.
The Swedish TeleStroke Program is part of an integrated effort to improve stroke diagnosis and treatment throughout Washington state. It is modeled after the country’s first program at Massachusetts General Hospital (MGH), a founding member of the Partners HealthCare System in Boston.
Through a secure videoconferencing network, Swedish’s stroke program is able to provide real-time, expert assessment of patients arriving with stroke-like symptoms. Around the clock, stroke specialists based at Swedish/Cherry Hill are able to perform “virtual” bedside neurological evaluations during which they are able to examine patients, review brain images and quickly select the best acute stroke treatments in collaboration with local ER staffs.
Stroke is the third largest cause of death and a leading cause of serious, long-term disability in the U.S.. The American Stroke Association says about 700,000 Americans suffer a new or recurrent stroke each year. That means, on average, a stroke occurs every 45 seconds and about every three minutes, someone dies of stroke.
Over the past decade stroke care has improved in various ways. Examples include newer diagnostic tests that are available to help pinpoint the location of a clot, and newer therapeutic treatments that may help reverse or minimize the impact of a stroke. However, these treatments are time-dependent and, as a result, most effective when they can be provided in the nearest emergency room. Unfortunately, many ERs do not have the volume or support to provide American Heart Association-recommended stroke evaluations and treatments. Telemedicine provides an effective way of bringing to the patient's community ER the same level of expert care available at a major medical center with an experienced stroke program.
The Swedish stroke program hub is located in the James Tower on the Cherry Hill Campus in Seattle. When a rescue candidate stroke patient arrives in an ER at any time of the day or night, the Swedish stroke team is paged. Members of the team include a stroke physician in coordination with a specially trained stroke nurse practitioner/physician or registered nurse can log in on their home or office computers to complete a TeleStroke examination and determine if a patient might qualify for available rescue therapies in an attempt to stop the stroke. The most common rescue therapy that the stroke team would use is an FDA-approved medicine called tissue plasminogen activator or tPA. This medicine can reverse the devastating effects of stroke for some patients if it is administered within three hours of the onset of a stroke.
“All four Swedish campuses - First Hill, Cherry Hill, Ballard and Issaquah - are certified as primary stroke centers by the Joint Commission for the Accreditation of Healthcare Organizations,” said William Likosky, M.D., medical director of the Swedish stroke program. “TeleStroke is another important tool in our arsenal against the third leading cause of death in the United States and the number-one cause of adult disability.”
MGH clinicians provided software and TeleStroke implementation support to Swedish over the past several months. In preparation for phase one of the project - in which Swedish implemented TeleStroke support for its Ballard and Issaquah campuses - a total of 14 Swedish stroke team clinicians were trained on the TeleStroke system, primarily via videoconferencing.
The technology costs for phase one of the Swedish TeleStroke Program amounted to less than $100,000, which was entirely funded by the Swedish Foundation and its generous donors. The Swedish Foundation is now in the process of raising funds to support subsequent phases of the program.
For more information: www.massgeneral.org, www.swedish.org