For physicians tended to stroke patients, the problem lies in the time needed to determine if the individual requires tissue plasminogen activator (tPA). To quicken this decision-making process, Kaiser Permanente implemented a telestroke program that has show an increase tPA use by 73 percent of patients with acute ischemic stroke.
The telestroke program, like other telemedicine programs, allows hospitals access to a neurologist while the acute ischemic stroke patient is still in route to the hospital. The neurologist is able to view diagnostic images of the brain and asses the patient through video, which can save precious time. The neurologist can then decide if the patient is a candidate for tPA, which is more effective the sooner it is administered.
"Our findings add to the existing body of evidence supporting the value of telestroke programs for improving tPA administration rates among ischemic stroke patients at hospitals which may have limited resources or access to neurological expertise," explained Adam L. Sharp, MD, study lead author of Kaiser Permanente Southern California's department of research and evaluation.
Kaiser Permanente conducted a study that analyzed 2,657 patients at 11 Kaiser medical centers, both before and after the implementation of the telestroke program. Before the program was put in place eight of the medical centers were less likely to give tPA compared with facilities receiving the largest volume of stroke patients. After implementation all facilities were as likely as the next to administer tPA. Other results included an increase in the use of tPA from 6.3 to 11 percent, a decrease in bleeding complications from 5.1 to 4.9 percent and a decrease in time to receive diagnostic imaging from 56 to 44 minutes. Overall, the time needed to administer tPA fell from 66 to 55 minutes.