MDNews - South Central Pennsylvania

IN OCTOBER 2013, THE two sys- tems joined forces to expand critical stroke care services at hospitals that are part of WellSpan and Summit, using telestroke technology. When patients suspected of suffering a stroke arrive at partner hospitals miles away, the system's audiovisual capa- bilities enable WellSpan stroke specialists to remotely examine them. "The telestroke program is equivalent to having a stroke specialist on-site and ensures we're providing the best stroke treatments possible," says Lori Clark, Vice President of Neurosciences at WellSpan Health. "It's the future of stroke care." Time Is Brain Arterial clots in the brain cause the vast majority of strokes, and for every minute that passes before physicians restore circulation, patients lose 2 million brain cells, resulting in brain damage, disability or death, accord- ing to the National Stroke Association. The telestroke program was established to make lifesaving and function-preserving treatments available in community hospi- tals that previously had limited access to advanced stroke treatments. Prior to the partnership with WellSpan, Summit Health's Chambersburg and Waynesboro hospitals relied upon two neurologists for stroke care. Restricted access to specialists, coupled with the fact that patients often arrive for care after the four-and-a-half-hour timeframe dur- ing which intravenous tissue plasminogen activator (tPA) — currently the gold stan- dard of clot-busting medication — can be delivered, significantly limited available courses of care. Beaming In Expertise WellSpan originally started the telestroke program at WellSpan Gettysburg Hospital. Now the program also gives providers at Summit Health's Chambersburg and Waynesboro hospitals immediate access to WellSpan stroke specialists, who are on- call 24/7 and have access to the Skype-like technology both at WellSpan York Hospital and their homes. Providers roll a cart with a high-defini- tion monitor and high-resolution camera into the patient's room so that the WellSpan stroke specialist can evaluate the more nuanced signs of smaller strokes by remotely controlling the camera with a touchpad. Then, stroke specialists confer with emergency department physicians and the patient's family and review CT scans and medical histories via electronic hea lt h record s to deter m ine t he appropriate treatment. John Mingle, MD, Medical Director of WellSpan's stroke program, notes that the most important thing about the telestroke program is that it expands the availability of intravenous tPA to more patients. "Administering tPA is complicated, and there are numerous inclusion and exclusion criteria," he explains. "While many physi- cians at WellSpan Gettysburg Hospital and Summit Health hospitals are comfort- able administering the medicine without support, some physicians shy away from it because of the high risk. This partnership helps ensure that we provide the treatment to all patients who qualify for it." Expanding Treatment Windows After the window for tPA closes, there are few treatment options, notes Sanjay Dhar, MD, Medical Director for Telehealth and the Stroke Program and a hospitalist at Summit Health. "For patients arriving after the tPA window, no good treatments were available locally," he says. "Telemedicine has allowed faster access to stroke specialists and an interventional neuroradiologist at WellSpan York Hospital. They provide additional treatment options, including mechanical removal of a clot in case of an acute stroke, expanding treatment timelines as much as 12 hours after stroke onset." ■ A NEW PARTNERSHIP BETWEEN WellSpan HEALTH AND SUMMIT HEALTH ENHANCES EMERGENT STROKE CARE AVAILABLE IN ADAMS, FRANKLIN AND YORK COUNTIES AND EXPANDS ACCESS TO TREATMENT TO SURROUNDING COUNTIES. Working Together for Lifesaving Stroke Care Bill Steinour, MD, WellSpan Gettysburg Hospital emergency department physician and Medical Director, and Betty Hutchison, RN, clinical educator, use telestroke technology during a simulation for a video consultation with a WellSpan neurologist. The technology consists of a sophisticated computer system, a webcam with a high- resolution camera and a high-definition monitor. By Michael Ferguson +++++++++++++++++++++++++ + +++ + +++ +++++++++++++++++++++++++ STROKE TREATMENT ❯ 1 8 | South Central Pennsylvania MD NEWS ■ M D N E W S . CO M

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