Stroke victims, whose recovery depends on quick medical attention, now can be seen by a neurosurgeon in Denver via a new Skype-style hookup at Mercy Regional Medical Center.
The Telemedicine Robot in the Mercy emergency department, one of 13 similar systems in the state tied to the Colorado Neurological Institute, consists of a camera, a screen and a microphone mounted on a wheeled stand. A keyboard is needed only for trouble-shooting the system itself.
The neurosurgeon, who appears on the screen, can see, through the camera, the patient and attending physician and nurses. They communicate via the microphone.
“It's incredibly valuable because we get their expertise,” said Dr. Jack McManus, medical director of the Mercy emergency department. “It's like having a stroke center right here.”
Dr. Christopher Fanale is a neurosurgeon with Blue Sky Neurosciences and medical director of the Colorado Neurological Institute stroke center. Fanale and other Blue Sky neurosurgeons see 700 stroke victims a year at Swedish Medical Center in Englewood.
Time is of the essence in treating stroke (a blockage of blood to the brain), Fanale said.
“We have a tight time window to treat patients,” Fanale said. “We're on call 24/7, so with my laptop, I can be anywhere in five minutes. If I'm at home and have to go to a local hospital, it can take 20 minutes.”
Neurosurgeons use the National Institute of Health scoring system to locate the blockage and determine how serious it is by observing the patient and asking questions, Fanale said.
“A side benefit is we can talk to family members,“ he said. “It's some comfort when we can establish an interaction at bedside.”
Paul Gibson, emergency/trauma director at Mercy, said: “Our goal is to do a CAT scan and get the drug t-PA to the patient within one hour. The drug t-PA is a clot buster that minimizes damage by restoring blood to the brain.”
Luanne Williams, executive director of the Colorado Neurological Institute, said telemedicine diagnosis and treatment of patients with acute stroke has exceeded expectations.
“The program has been very successful, beyond our initial dreams,” Williams said. “More than 300 patients have received a diagnosis since the telemedicine program began in May 2006 in Vail.
“There is a huge shortage of doctors trained in stroke neurology,” she said. “Telemedicine diagnoses allow patients to remain in their community unless they have to be transferred to a big urban hospital.”
Mercy, which has no neurosurgeon on staff, sees 10 to 12 stroke patients a month, Gibson said. The hospital began using telemedicine technology for stroke victims in late December.
Mercy would like to use the system for more than stroke patients, Gibson said.
That's in the works, Williams said. A pilot study of applying telemedicine in trauma cases is scheduled to start at a hospital in Springfield.
Telemedicine technology lends itself to diagnosing stroke because there are visual symptoms such as a lopsided smile or a droopy arm, Gibson said. The victim also may have slurred speech or trouble seeing.
“In the past, our physicians, upon seeing stroke symptoms, could consult a neurosurgeon in Denver by phone to decide whether to send the patient there,” Gibson said. “The new technology allows more rapid diagnosis, and we can start thrombolitic therapy sooner.”
Country music great Charlie Daniels was treated at Mercy in January after suffering a stroke while snowmobiling in the backcountry. Daniels, whose left side became numb, recognized stroke symptoms and sought help.
Mercy physicians administered t-PA to Daniels and consulted a neurosurgeon in Denver. But the teleconferencing was not used, Gibson said.