[October 2008] Yale-New Haven Hospital (YNHH) has initiated Connecticut's first stroke telemedicine program. The Yale-New Haven TeleStroke Network utilizes high-speed network videoconferencing and image-sharing technology with partner hospitals to rapidly assess and consult with partners on treatment options for acute stroke victims.
Lawrence and Memorial Hospital (L&M) in New London is the first hospital in Connecticut to partner with YNHH in the TeleStroke Network. On August 14, a 67-year- old woman from East Lyme, who experienced sudden onset acute stroke symptoms while swimming, was diagnosed and treated with tPA, a clot-busting medicine within 37 minutes of her arrival at the L&M emergency department. She was transferred later that day to YNHH and although her speech was affected by the stroke, she continues to improve.
"We have demonstrated that with a collaborative, multi-disciplinary team, we can support the clinical staff at L&M during the acute stroke phase and administer tPA well within the nationally recommended time of 60 minutes," noted Joseph Schindler, MD, clinical director of the YNHH stroke center. "From there, we can transfer patients with more complex neurological issues to YNHH's neuro-intensive care unit where expert stroke management is available."
About 80% of strokes are ischemic strokes in which a blood clot, becomes lodged, blocking the blood flow to that area. The preferred treatment is to administer tissue plasminogen activator (tPA), a clot busting drug that can greatly reduce the disability resulting from a stroke. tPA must be administered within 3 hours of the onset of symptoms. Unfortunately, some hospitals lack the resources to make this determination and cannot physically transfer the patient quickly enough to enable them to receive this therapy if warranted. TeleStroke can enable subscribing hospitals to provide expert acute stroke care for patients without physically transferring the patient to YNHH for diagnosis.
"The implementation of telestroke programs have demonstrated that telestroke conferencing between outlaying emergency departments and trained stroke neurologists can enhance the use of tPA at those facilities that do not have 24/7 access to neurologic expertise," added Dr. Schindler. "We are hopeful that more hospitals throughout Connecticut will join this vital life-saving network."
Stroke certification was added to the Joint Commission's (TJC) disease-specific care certification programs in November of 2004. TJC, in collaboration with the Brain Attack Coalition and the American Stroke Association, developed a certification process for the designation of Primary Stroke Center, a disease-specific care certification which recognizes an institution's commitment to excellence in disease management. Yale-New Haven Hospital is one of 350 medical facilities throughout the United States that have met the stringent criteria for delivering evidence-based clinical care and for implementing performance improvement activities for the treatment of stroke. In addition, both YNHH and L&M are designated as Primary Stroke Centers by the Connecticut Department of Public Health.