Telestroke ‘a model for COVID-19 care and beyond’

19 May 2020

Saving lives and improving post-stroke outcomes, Telestroke is being hailed as a model for care during COVID-19 and beyond in its use of telehealth technology to virtually assess and treat stroke patients in regional and rural NSW.

During the COVID-19 pandemic, Telestroke is being used to even greater effect, given that stroke specialists don’t need to be in the same room as their patients, ensuring social distancing.

COVID-19 struck just as the Telestroke state-wide service was poised to launch from its new headquarters at Prince of Wales Hospital (POWH) in Sydney’s east.

Despite the outbreak of the global pandemic, the Telestroke service has continued to spread this life-saving model of hyper-acute care to hospitals in Port Macquarie and Coffs Harbour on the mid north coast.

“Telestroke is a model for COVID-19 care and beyond, as it’s all about bringing better outcomes for stroke patients,” said Professor Ken Butcher, Medical Director of the NSW Telestroke Service and Director of Clinical Neuroscience at the University of NSW.

“The outbreak of COVID-19 got us thinking that this type of technology would be invaluable should NSW Health’s medical workforce be severely affected by coronavirus.

“If, for example, stroke specialists had to self-isolate but were well enough to work, they could still deliver care to patients of stroke, which – COVID or no COVID – is always going to be a critical issue.”

Telehealth delivering time-critical stroke treatment

Every year, around 19,000 residents of NSW have a stroke. NSW is home to 12 of Australia’s top-20 hotspots for stroke incidence, and 10 of these 12 are in regional and rural areas.

To deliver time-critical care, Telstroke links city-based specialists with people presenting with stroke symptoms to rural and regional health facilities, providing equity of access to stroke specialists, diagnosis and treatment.

Using screen-sharing technology provided by the state’s digital health agency eHealth NSW, remote specialists gain full access to world-class patient imaging as it is being processed – allowing time-critical diagnosis and immediate treatment of stroke patients.

This means that if a patient in Port Macquarie has a stroke, they can be assessed by city-based stroke specialists using Telestroke kiosks equipped with high-definition cameras and audio devices and linked to NSW Health’s electronic medical record systems.

“You dial in and then you’re in front of a patient,” said Professor Butcher. “This is technology that needs to be utilised more to improve the care of stroke patients and to teach trainee doctors not only during but after hours, too.”

Telestroke tech helps protects doctors and patients during COVID-19

To adhere with COVID-19-enforced social distancing rules, Professor Butcher recently used Telestroke technology to treat a stroke patient in the Emergency Department of Prince of Wales Hospital. He was a few floors away.

“The patient had transient symptoms following two previous strokes so we assessed her vital signs and conducted a neurological examination via Skype for Business, and I was able to view her scans which were clean,” he said. “It was a good outcome for her and she is now back living independently.”

For Professor Butcher, Telestroke has the power to improve the timeliness and accuracy of stroke assessment, diagnosis and treatment, all of which makes it more likely that patients will receive all-important reperfusion therapy to restore blood flow through or around blocked arteries.

“The efforts to fight COVID-19 have taken over for the time being but we are pushing ahead with plans to get Telestroke established in hospitals in Shoalhaven, Lismore, Tamworth, Dubbo, Orange, Wagga Wagga, Griffith, Nepean, Bathurst, Armidale, Manning and Tweed,” said Professor Butcher.

“After that we will go into Moree, Blue Mountains, Lithgow, Grafton, Broken Hill and Deniliquin Hospitals.”

The Telestroke model of care was originally developed by the Agency for Clinical Innovation with the support of eHealth NSW and clinicians from Hunter New England, Mid North Coast and Central Coast Local Health Districts.

Stroke stats

  • Almost 2.5 million people live outside the main population areas of Greater Sydney, Newcastle and the Illawarra.
  • NSW is home to 12 of the country’s top 20 hotspots for stroke incidence, and 10 are located in regional and rural areas.
  • Regional Australians are 19 per cent more likely to have a stroke than their city counterparts.
  • Regional Australians are more likely to die or be left with a serious disability as a result of stroke because they do not have access to time-critical stroke treatment and specialist care.
  • By 2050, it is estimated that more than 45,000 strokes will occur every year in NSW.

Source: The Stroke Foundation

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