Memorial stroke & gpt

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

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Memorial stroke & gpt

by Lloyd Sirmons on Mar 15, 2011

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Memorial stroke & gpt — Presentation Transcript