Acute stroke care capacity and services are lacking in many hospitals in the Northwest region, particularly in rural hospitals. Of most concern is access to acute stroke care personnel, especially in rural areas where only 1 in every 8 hospitals have access to a neurologist either in-person or by phone. This most likely contributes at least in part to only 53% of rural hospitals in the NW region having administered t-PA; the recommended treatment for strokes caused by blood clots -- even once in the past year. Emergency personnel often cite the lack of neurology consultation as one of the reasons for not giving t-PA more often.
In a recently released survey of hospitals and other healthcare providers in the Northwest (AK, ID, MT, OR, UT, WA, WY), an overwhelming 88 percent of respondents said their rural communities suffer from a lack of stroke neurologists. Sixty four percent are currently in the process or considering development of a telestroke program to address this lack of local neurology resources.
Telestroke is a form of telemedicine; using real-time telephone and/or video conferencing technologies. Telestroke programs link hospitals to regional stroke centers, with specially trained neurologists, and increase patient access to specialized care; especially when travel and distance are an issue.
The Regional Telestroke Initiative (RTI) released the results of this comprehensive survey . It was designed to understand the capacity and use of telestroke care in the Northwestern United States. The results will help improve stroke care in the region by bringing attention to the rural-urban disparities in stroke treatment and increasing capacity of rural hospitals to treat stroke patients.
There are upfront costs to providers who implement telestroke programs and professional consultations are not always covered by insurers, even though they may lead to reduced severity of impairment and future medical costs. Of those organizations currently providing telestroke services, the leading sources of funding are stroke specialty tertiary (hub) hospitals (28%) and grant funding (21%). When it comes to reimbursement for a neurologist’s on-call telestroke time, 32.6% report that the hub hospital covers the cost, and 32.6% report no reimbursement for the services they provide.
These results emphasize the need for the RTI to continue its efforts to help providers improve their telemedicine capacity and stroke care services. Survey findings will help providers recognize regional assets, so they can take advantage of broadband capabilities and expanding telehealth networks to support those communities without sufficient stroke specialists.
Recent federal actions to reform the healthcare delivery system and emerging trends present new opportunities to highlight the real value offered by telestroke programs. The RTI will continue to address persistent barriers to telestroke development and leverage the considerable expertise and infrastructure in the region to standardized practices and improve interstate licensure, credentialing and reimbursement. This will lead to increased consideration of tPA administration with greater access for patients in rural communities, improved outcomes, and reduced morbidity and mortality due to stroke.
The RTI is now planning educational opportunities to respond to the needs identified by the survey and build upon progress that has already been made. These educational opportunities will include best practices in the delivery of acute stroke treatment and successful telestroke solutions across the region. Additionally, RTI members will participate in efforts to remove state, regional and national policies that create barriers at both the provider and system levels.
To review the full survey results, visit http://strokeforum.doh.wa.gov/links/regional-telestroke-initiative .
For information on the warning signs of stroke visit the American Stroke Association .
Acute stroke care capacity and services are lacking in many hospitals in the Northwest region, particularly in rural hospitals. Of most concern is access to acute stroke care personnel, especially in rural areas where only 1 in every 8 hospitals have access to a neurologist either in-person or by phone. This most likely contributes at least in part to only 53% of rural hospitals in the NW region having administered t-PA; the recommended treatment for strokes caused by blood clots -- even once in the past year. Emergency personnel often cite the lack of neurology consultation as one of the reasons for not giving t-PA more often.
In a recently released survey of hospitals and other healthcare providers in the Northwest (AK, ID, MT, OR, UT, WA, WY), an overwhelming 88 percent of respondents said their rural communities suffer from a lack of stroke neurologists. Sixty four percent are currently in the process or considering development of a telestroke program to address this lack of local neurology resources.
Telestroke is a form of telemedicine; using real-time telephone and/or video conferencing technologies. Telestroke programs link hospitals to regional stroke centers, with specially trained neurologists, and increase patient access to specialized care; especially when travel and distance are an issue.
The Regional Telestroke Initiative (RTI) released the results of this comprehensive survey . It was designed to understand the capacity and use of telestroke care in the Northwestern United States. The results will help improve stroke care in the region by bringing attention to the rural-urban disparities in stroke treatment and increasing capacity of rural hospitals to treat stroke patients.
There are upfront costs to providers who implement telestroke programs and professional consultations are not always covered by insurers, even though they may lead to reduced severity of impairment and future medical costs. Of those organizations currently providing telestroke services, the leading sources of funding are stroke specialty tertiary (hub) hospitals (28%) and grant funding (21%). When it comes to reimbursement for a neurologist’s on-call telestroke time, 32.6% report that the hub hospital covers the cost, and 32.6% report no reimbursement for the services they provide.
These results emphasize the need for the RTI to continue its efforts to help providers improve their telemedicine capacity and stroke care services. Survey findings will help providers recognize regional assets, so they can take advantage of broadband capabilities and expanding telehealth networks to support those communities without sufficient stroke specialists.
Recent federal actions to reform the healthcare delivery system and emerging trends present new opportunities to highlight the real value offered by telestroke programs. The RTI will continue to address persistent barriers to telestroke development and leverage the considerable expertise and infrastructure in the region to standardized practices and improve interstate licensure, credentialing and reimbursement. This will lead to increased consideration of tPA administration with greater access for patients in rural communities, improved outcomes, and reduced morbidity and mortality due to stroke.
The RTI is now planning educational opportunities to respond to the needs identified by the survey and build upon progress that has already been made. These educational opportunities will include best practices in the delivery of acute stroke treatment and successful telestroke solutions across the region. Additionally, RTI members will participate in efforts to remove state, regional and national policies that create barriers at both the provider and system levels.
To review the full survey results, visit http://strokeforum.doh.wa.gov/links/regional-telestroke-initiative .
For information on the warning signs of stroke visit the American Stroke Association .