Telehealth helping to fight stroke

8 May 2018

When Col Carter suddenly became unable to move his left arm and left leg and could not see out of his left eye or talk, his wife Sharon feared the worst and called an ambulance to their home in the NSW mid north coast township of Kempsey.

“The paramedics told me Col was having a stroke and took him straight to Port Macquarie Hospital’s Emergency Department,” said Sharon. “It was an incredibly worrying and stressful time.”

A new project called Telestroke, led by eHealth NSW and the Agency for Clinical Innovation (ACI), is improving outcomes for patients like 68-year-old Col, who has recovered as well as possible from a stroke which could have caused far more severe health problems.

Upon assessing Col at Port Macquarie Hospital around midnight, Dr Daniel Smith knew they had to act fast. He arranged for Col to be ‘seen’ by Dr Bill O’Brien, a neurologist based 350km away at Gosford Hospital on the Central Coast, using NSW Health’s universal communications platform Skype for Business.

Upon virtually assessing Col’s case and reviewing his brain scans, Dr O’Brien immediately recognised the severity of Col’s condition and referred his case to Dr Ferdinand Miteff at Newcastle’s John Hunter Hospital. The team organised for Col to be airlifted to John Hunter Hospital at 3am, allowing Dr Miteff to perform critical clot retrieval surgery without delay.

“Col went from having no movement in his left arm or left leg and no vision in his left eye and being unable to speak, to be able to move and see again and in recovery the next morning at 7am,” said his wife Sharon. “It was amazing.”

Col benefited from an exciting and life-saving new telehealth project that harnesses technology and breaks down barriers to time-critical treatments for stroke sufferers in regional NSW.

The Telestroke project is improving outcomes for patients who present to Port Macquarie and Coffs Harbour Hospitals with stroke symptoms.

With plans for it to be extended to hospitals in Hunter New England and the Central Coast ahead of potential statewide implementation, the Telestroke project is enabling patients to have a brain scan onsite, which is then assessed in real time by a remote neurologist.

The specialist provides a diagnosis and treatment can begin immediately. Previously patients may have needed to be transferred to city hospitals, which delayed their treatment for hours.

Up to 1.9 million brain cells die each minute following a stroke, making treatment time-critical and crucial to a patient’s chances of recovery.

Almost 19,000 strokes will take place in NSW in 2018 alone and many of those will occur in regional areas which have a higher incidence of stroke but fewer specialist physicians, said ACI Stroke Network Manager Kate Jackson.

“The Telestroke project allows us to bridge distances and deliver world-class stroke assessment, treatment and management, irrespective of location,’’ said Ms Jackson.

“Regional Australians are 19 per cent more likely to suffer a stroke than their metropolitan counterparts. All Australians should have access to best-practice treatment and this is a major step in the right direction.”

Stroke Foundation NSW State Manager Teresa Howarth said while the results of this project were preliminary, they demonstrated the power of telehealth across NSW and Australia.

“Stroke is one of Australia’s biggest killers and a leading cause of disability, but it does not need to be this way,’’ said Ms Howarth.

“Stroke can be treated. We must ensure all Australians – no matter where they live – have access to the stroke treatment we know saves lives and reduces disability.

“The Telestroke project is already making a difference to stroke services on NSW’s Mid North Coast and a similar program has had some fantastic outcomes in Victoria.”

Ms Howarth said being cared for by a specialised stroke team is one of the most effective ways of treating a person after a stroke.

“As our population ages and lifestyles become more sedentary, stroke’s burden on the community and health system is increasing,” she said. “We must continue to make the most of the technology available to us to save lives and enhance recovery.”

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