Memorial stroke & gpt
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Memorial stroke & gpt

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Memorial stroke & gpt Memorial stroke & gpt Presentation Transcript

  • Memorial Health University Medical Center TeleStroke Platform : Development in Collaboration with Georgia Partnership for TeleHealth
  • Presentation Agenda
    • Memorial Health’s Mission, Vision, and Values
    • Memorial Health’s Demographics and Target Population
    • Telemedicine Funding
    • Memorial Stroke Program Overview
    • Development of TeleStroke Platform
    • Platform Demonstration
  • Mission, Vision, and Values
    • Mission: With compassion, we heal, teach, and discover.
    • Vision: We will create a new standard for healthcare by integrating compassionate healing, lifelong learning, and scientific discovery.
    • Values: Trust
    • R espect
    • World-class
    • Enjoyment
    • My Memorial
  • Memorial Health
    • Founded in 1955
    • Non-profit, two-state healthcare system serving 35 counties in southeast Georgia and southern South Carolina
    • 530-bed tertiary hospital
    • 1 of 4 Level 1 Trauma Centers in Georgia
    • Region’s only
      • Academic Medical Center
      • Children’s Hospital
      • Level 3 Neonatal Intensive Care Nursery
      • Pediatric Surgeons, Pediatric Cancer Doctors, Pediatric Neurosurgeon, and High-Risk Obstetrics Practice
  • Telemedicine Funding at Memorial Health
    • One of four Level 1 Trauma Centers in GA
      • Providing the highest level of emergency care (American College of Surgeons)
      • Only Level 1 between Jacksonville, Fla. and Charleston, S.C.
    • Georgia Trauma Care Network Commission in collaboration with GPT was granted a USDA federal grant to develop and support trauma telemedicine
      • Grant to support equipment purchases to launch 4 pilot programs in rural trauma telemedicine
      • 5 Spoke Hospitals have been identified and have equipment in place
      • Trauma Telemedicine at MH is in the final development stages and set to go-live
      • Opportunity to create additional service to our region:
        • Trauma Telemedicine
        • Stroke Telemedicine
  • Memorial Health By The Numbers
    • 26,301 hospital admissions
    • 280,923 outpatient visits
    • 22,473 surgeries
    • 96,349 emergency visits
    • 5.53 days average LOS
    • 3,973 Team Members
    • 633 physicians on staff
    2010 Data
  • Camden Charlton Ware Clinch Atkinson Coffee Ben Hill Telfair Wheeler Jeff Davis Appling Pierce Brantley Glynn Wayne McIntosh Long Liberty Tattnall Toombs Montgomery Dodge Laurens Treutlen Candler Jenkins Bulloch Effingham Screven Evans Bryan Chatham Johnson Washington Jefferson Burke Richmond Aiken Barnwell Orangeburg Bamberg Allendale Hampton Colleton Dorchester Charleston Jasper Beaufort Bacon Emanuel Primary Secondary Tertiary Peripheral Extended Who we serve? (120 mile radius) 24 Counties EMS Region IX; 4 counties SC
  • Stroke Centers in Georgia (25 total as of May 2010) Underserved Region
  • Stroke Volumes at MHUMC 2010
    • Total Stroke Admits 623
    • Ischemic Stroke 59%
    • TIA 14%
    • Hemorrhagic Stroke (SAH/ICH) 27%
    • 50/50 Male to Female
    • 49% Caucasian 35% African American
    • LOS 4.49 days for Ischemic Stroke Patients
  • The Rehabilitation Institute
    • 50 bed rehabilitation center
      • 10 neuro beds (TBI secured unit)
      • CARF Certified for stroke rehabilitation and brain injury
      • In-Patient & Outpatient rehabilitation services
    • Primary goal: help patients return to an independent lifestyle
    • 238 CVA patients in 2010
      • LOS comparable to Regional Average (16.97 days)
      • Accept patients post CVA 3.62 days earlier than the average for Nation and Region. Patients admitted to rehab 8.32 post CVA on average.
      • Overall functional improvement (23.11 point improvement) – higher than National and Regional averages
      • 81.83% of our stroke patients are able to return home after rehabilitation versus long term care - 15.24% higher than National and Regional Averages
  •  
  • Distinctions
    • Memorial Health University Medical Center Awarded
    • • 5 star rating by HealthGrades for :
    • - Treatment of Stroke for 3 years in a row
    • - HealthGrades Stroke Care Excellence Award
    • - Top 5% in Nation for Treatment of Stroke
    • - Ranked #1 in State for Treatment of Stroke
    • 2010 GWTG Silver Achievement Award
    • 2010 TARGET: STROKE HONOR ROLL
    • - DTN times w/i 60 min on 50% of eligible patients for one quarter
    • - 1 st in state of GA & 1 of first 5 in nation
    • Re-certified as a Primary Stroke Center by TJC 2011
  • Stroke Facts
    • Stroke is a “brain attack”
    • Third leading cause of death and No. 1 cause of adult disability
    • Approximately 795,000 stroke occur each year
    • 87% Ischemic (blocked artery) 13% Hemorrhagic (broken vessel)
    • Two million brain cells die every minute during a stroke
    • TIME IS BRAIN! ACT FAST!
  • Benefits of Telestroke
    • Telestroke links community hospitals to a stroke specialist
      • Helps community hospitals to deliver evidence-based acute stroke management
      • Increase the number of eligible stroke patients who receive tPA
      • Improve patient outcomes, decrease stroke related disability, and reduce health care cost
      • Decreases the number of unnecessary transfers
    • Only FDA approved treatment for Ischemic Stroke
      • Clot busting drug called tPA (tissue plasminogen activator)
      • Administered w/i 3 hours of symptom onset
    • Thrombolytic therapy is rarely used in community hospitals
      • Lack of on-site stroke-care expertise, concern for hemorrhage, lack of neuroradiologists
  • Telestroke at Memorial Health
    • Telestroke at MH is a web-based, telemedicine system
      • Hub and Spoke Model
      • Utilizing real-time audio/video conferencing between hospitals
      • Data is collected and stored
      • Key Elements
      • Strong physician leadership - instrumental in the development and implementation of our custom-built stroke platform
      • Support from ED at spoke and hub hospitals
      • Share Stroke Order Sets and Protocols
      • Offer education to spoke hospitals
        • ASLS
        • tPA reconstitution & administration
        • Acute Stroke Management
  • Benefits to Telestroke
    • Advantages to telestroke versus telephone
      • Visualization of patients in the ED
      • Ability to perform a valid NIHSS
      • CT scan
      • Decreased travel time for physicians
      • Ability to take call from anywhere
    • Challenges to telestroke
      • Funding
      • Reimbursement
      • Software issues
      • Licensure
  • Telestroke Platform Demonstration
    • https:// stroke.gatelehealth.org
  • Comments or Questions