In this article, Dr. Jeffrey Switzer, DO, director of telestroke and teleneurology at Georgia Regents Medical Center in Augusta, discusses how telemedicine has impoved outcomes for victims of strokes.
The key issue was the waning time window in which physicians can intravenously administer tPA — tissue plasminogen activator — for Ischemic stroke patients, a drug that helps dissolve blood clots. tPA is only approved for administration within three hours of the onset of stroke symptoms, a window of time which Dr. Switzer says was sometimes impossible to achieve due to the distance between hospitals and the time it took to transfer patients.
In some cases, Dr. Switzer says a stroke specialist at Georgia Regents would be contacted by a physician at one of the rural hospitals for advice on a stroke patient. The stroke specialist would have to advise the rural clinician without seeing the patient, a practice the clinicians referred to as “tPA by Russian Roulette.”
The physicians discussed the feasibility of a program where stroke patients could be visually evaluated locally to reduce the need for hospital transfers.
“The impetus was to develop a system where in real-time we could evaluate these patients at their local facility and then make decisions there on what needs to be done and whether or not they would benefit from tPA treatment,” Dr. Switzer says. “Secondary to that, if they needed to be transferred, we could transfer them.”
Today, telemedicine allows patients in rural Georgia to be instantly evaluated by experts at Georgia Regents so they can get the timely care they need to avoid bad outcomes and hopefully allow them to make a full recovery.