Mobile Telemedicine System Speeds Stroke Care

A low-cost, tablet-based videoconferencing platform can help paramedics reliably perform prehospital neurologic assessments in both rural and urban settings.

Researchers at the University of Virginia Health System (UVHS, Charlottesville, USA), Stanford University (CA, USA), and other institutions conducted a pilot clinical trial of a mobile telemedicine system that uses commercial cellular networks for videoconferencing transmission. The system is based on a wall-mounted tablet that allows the hospital doctor to confer with the paramedic and the stroke patient in the ambulance. For the study, standardized patients portrayed scripted stroke scenarios during ambulance transport. The scenarios were evaluated by independent raters that compared bedside to remote mobile telestroke assessments.

In all, 27 ambulance runs at two test sites were successfully completed for all prehospital assessments without any prohibitive technical interruption. The researchers found that the system had sufficient quality and connectivity to allow successful consultations in over 90% of local test runs. The mean correlation of National Institutes of Health Stroke Scale (NIHSS) scores between bedside and mobile telestroke assessments was 96%. The study was published on June 6, 2016, in Neurology.

“Acute stroke is a very time-dependent illness. Specifically, in acute ischemic stroke, if you can remove the vascular obstruction and re-vascularize the injured part of the brain in a timely way, you can potentially prevent disability and death,” said lead author assistant professor of neurology Andrew Southerland, MD, MSc. “The goal of our study is to advance the assessment of acute stroke to the pre-hospital setting - to the ambulance transporting the patients to the hospital.”

Telemedicine is the use of communication and information technologies to provide health care at a distance and improve access to medical services not consistently available in distant rural communities. Although there are distant precursors to telemedicine, it is essentially a product of 20th century telecommunication and information technologies that permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging and health informatics data from one site to another.

Related Links:
University of Virginia Health System
Stanford University