Advanced Care for Stroke Patients
Acute stroke patients who arrive at Rush-Copley’s Emergency Room can now be seen immediately by a Rush University Medical Center stroke neurologist without the specialist actually being there. Rush-Copley has teamed up with the highly specialized stroke treatment team at Rush to make a neurologist remotely available 24/7 using a new technology called a telemedicine robot. The Rush stroke neurologist can log into a computer from anywhere and not only speak, but also see the patient and the patient’s medical information in real-time to provide an evaluation and help direct treatment recommendations.
The system is comprised of a remote robot placed in the emergency department and a control station using a laptop computer that has secure Internet connection. Through the computer, the neurologist at Rush can control the camera to pan and zoom to view and speak with the patient, family members, and medical staff. The patient at Rush-Copley can see the physician on the robot’s screen, which allows for a personal exchange and two-way communication.
This new technology helps address the major challenges confronting stroke care: the short time window available for treatment and the limited availability of stroke neurologists who are required to swiftly and accurately diagnose stroke.
A physical exam to determine if a patient should get life saving clot busting drugs depends mostly on observation by a specially-trained stroke neurologist who monitors speech, level of consciousness, and the patient’s ability to move.
Patients have only an eight hour window of time for potential interventional procedures and a much shorter four and half hour window from onset of symptoms to receive the clot busting drug, tPA. A stroke trained neurologist is needed to make these treatment decisions. Treatments to open up blocked blood vessels in stroke have been shown to improve outcomes and limit disability. However, too few patients receive these approved therapies due to delays in arrival or treatment in the hospital.
The robotic technology is like combining Skype with a stethoscope. The robot is wheeled into the patient’s room in the ER, places it bedside, and the neurologist at Rush located at the other end of the electronic feed is able to control it the rest of the way.
The robot allows consulting doctors to pan in close enough to view a patient’s pupils and other vital signs, tilt up and down, spin around 360 degrees, read CT scans, and talk to the patient and emergency room staff. The physician has access to the patient’s medical information through an electronic medical record. Since the system uses a laptop computer, the stroke neurologist can log on from just about anywhere and provide a crucial time-sensitive evaluations and recommendations.