Temple now offering stroke telemedicine services at Lower Bucks Hospital under new agreement.
By Samantha Bambino
“Every second counts when a patient shows symptoms of a stroke,” said Paul M. Katz, director of the stroke program at Temple University Hospital.
In a true emergency, a hospital only has three hours from the time stroke symptoms begin to administer a clot-busting medication, otherwise the patient will suffer permanent disability. In a new clinical partnership to provide the most efficient care, Temple University Hospital neurologists will use telemedicine services to treat acute stroke patients at Lower Bucks Hospital in Bristol.
According to Dr. David Jaslow, chairman and EMS director at Lower Bucks Hospital, this partnership with Temple has been in the works for months. As a small local hospital, LBH had a serious need for a specialized neurologist, but there aren’t enough in the field. The ones who exist don’t have time to drive to various locations, and LBH doesn’t get enough stroke patients to have the resources to hire someone full-time.
This is where telemedicine comes in. While LBH may not have all of the resources, Temple does. With its highly advanced equipment and specialties, neurologists in North Philly can diagnose and treat a patient in Bucks County in five minutes through live video conferencing, any hour or day. The same quality of treatment is guaranteed each time.
As a primary stroke center, LBH staff has received in-house training and recent approval from the state Department of Health and the Heart Association. According to Jaslow, there is a strict process set in place. After a family recognizes stroke symptoms and calls, EMS is sent and the emergency department is alerted so it can begin preparing the CAT scan. Potential stroke patients are made a top priority over non-critical patients since treatment is so time sensitive.
When the ambulance arrives, a team is waiting by the entrance. Jaslow compares this part of the process to car racing.
“The car comes in the pit, and within 10 seconds, it’s fueled and they’re out. We wanted to model the process after that,” he said.
While at the doors and still on the stretcher, a registration clerk gets the patient’s name and date of birth to generate a wristband, blood pressure and sugar are taken by a charge nurse, then they’re immediately wheeled to the CAT scan. The process up to this point takes less than two minutes.
By the time they’re out of the scan, the Temple neurologist is on the computer in the patient’s room. They can instantly see the scan and interact with the patient and family members in real time through video. The neurologist performs a remote physical exam to see if they qualify for the clot-busting medicine, which costs $3,500-$5,000 a dose and must be treated carefully. According to Jaslow, the total time from when the patient comes through the door to when they’re in the room is 10 minutes.
Before this partnership, LBH did not have 24/7 access to a neurologist. Now, it is paired with physicians who have hot spots in their cars and will pull over to diagnose a potential stroke patient. If it is an emergency and something LBH isn’t equipped to handle, Temple will transport the patient to its hospital by helicopter. Once treated, Temple will transport them back to Bucks County for physical therapy and any follow-up visits. Since Temple is nowhere near LBH geographically, there is no competition for patients.
Since the start of the partnership on May 8, LBH has reached out with two stroke calls to Temple, though both were minor. Katz sees this as a positive experience.
“I would rather get a false alarm than have the result of permanent disability,” he said. “LBH is being proactive and aggressive in wanting to help the patients.”
The past 30 years have seen great strides in treatment for stroke patients. In the ’80s, according to Jaslow, there were no drugs and it wasn’t seen as a true medical emergency. Medication started to emerge in the ’90s, and by 2000, there was a push to educate the public on how to recognize symptoms. The health community’s mission is to focus on hospital operations and making them as efficient as possible.
“This is a great opportunity to provide state-of-the-art care,” Jaslow said. “Everybody wins when you combine collaboration and technology.” ••