Bringing Top Notch Stroke Care to Community Hospitals
By Robin O’Connor
According to David Tong, M.D., medical director of the California Pacific Medical Center Stroke Program, a technology called Stroke Telemedicine makes it possible for patients at a small community hospital to receive an accurate diagnosis and treatment plan without being transferred to a specialty stoke center.
In 2005, Dr. Tong began working on Stroke Telemedicine, and within five years had the site up and running. Now, six years later, Dr. Tong and his team evaluate patients at seven Stroke Telemedicine locations. “The greatest advantage of Stroke Telemedicine is that we are able to see the patient and provide a comprehensive evaluation. Neurology conditions are very visual and visual quantification helps us make a more accurate diagnosis helping us avoid unnecessary patient transfers,” explains Dr. Tong.
Sutter Health’s Novato Community Hospital is the only hospital in northern Marin County. A 47-bed facility, Novato, like many smaller facilities, does not have a dedicated stroke neurologist. But with telemedicine technology, like California Pacific Medical Center’s Stroke Telemedicine program, Novato Community Hospital patients and emergency physicians have 24/7 access to Joint Commission Certified Stroke Program neurologists located in San Francisco.
How does Stroke Telemedicine work?
When a patient arrives with a suspected neurologic condition at a Stroke Telemedicine hospital, the emergency physician consults with the on-call CPMC stroke neurologist. Within minutes, the physicians are working together with the patient via two-way, high-definition video conferencing. The local emergency department staff assists the CPMC neurologist in performing a neurologic examination to determine if the patient has experienced a stroke, because many neurologic conditions mimic stroke. Then the team consults on the best treatment options for the best patient outcome.
Taking the disability out of stroke
Stroke is the No. 1 cause of disability in the United States. Most strokes are caused by a clot in the carotid artery, which supplies blood to the brain. Administering tissue plasminogen activator (tPA), a clot-busting drug, in the first 3 to 4.5 hours after the start of symptoms, has been extremely effective in treating ischemic stroke. Dr. Tong says, “Fifty percent to 60 percent of patients who receive tPA for stroke have little or no long-lasting effects from their stroke. The other 40 percent usually have a lesser degree of post-stroke-related complications. The dosage of tPA can be tricky, and a stroke neurologist can safely guide the administration of tPA. Many physicians find having a neurologist involved enhances patient care and patient outcome.”
Not all strokes are caused by blood flow blockage. An aneurysm, a bulge or ballooning in a blood vessel in the brain, can’t be treated with tPA. At Novato, when an aneurysm is detected or suspected, immediate transport services are available to transport patients to a hospital with a higher level of care. “Stroke Telemedicine helps us triage patients so they receive the best treatment for their condition,” says Dr. Tong.
“Working with CPMC has been a real boon for our patients,” states Timothy Gee, M.D., vice president of medical affairs at Novato Community Hospital and an emergency medicine physician. “Stroke patients have immediate access to a stroke neurologist,“ Dr. Gee adds.
Telemedicine: keeping quality care close to home
Using Stroke Telemedicine has worked very well for smaller medical facilities like Novato. Emergency physicians are pleased to have the consulting expertise when a stroke patient or any neurology patient arrives in their emergency room. Patients appreciate having an expert physician on their team without having to travel far from home and family.
“Brain GPS” Provides Route to Better Care
Thanks to offerings like our Stroke Telemedicine Program, the demand for services of CPMC’s Neurosciences Institute has grown rapidly. In turn, that success has accelerated our need to acquire more leading edge technology in all service lines throughout the Institute to ensure our patients get the best possible care. One of our most pressing equipment needs right now is securing a second, more advanced Cranial Navigation System.
Offering “augmented reality” 3D imaging, this technology is like having a GPS map of the patient’s brain. It allows physicians to visualize exactly where they are at all times during a procedure, employing the safest and least invasive routes to the affected area.
Your generous donation toward funding the acquisition of this amazing equipment could help contribute to quicker recovery times and shorter hospital stays for patients needing these services. To make your gift, please contact CPMC Foundation at 415-600-4400 or visit the CPMC Foundation website.