Have a stroke in Birmingham and chances are you may be treated at University of Alabama at Birmingham Hospital — a hospital with a specialized stroke unit and neurologists, neurosurgeons, neuroradiologists and other health-care professionals trained in stroke care on duty 24/7.
Have a stroke elsewhere in Alabama, and the situation may be different. Many small community hospitals don’t have the necessary resources on hand every hour of every day to treat a stroke. There may not be a neurologist or other medical professionals integral to stroke care on duty.
One way to bridge this gap in stroke coverage is through telemedicine, using advanced video technology to let a physician in one location help manage the treatment of a patient who is somewhere else.
UAB has developed a business relationship with Specialists on Call (SOC) to enable better access to neurological services and stroke care throughout Alabama using telemedicine. SOC is a Joint Commission-accredited organization of board-certified, specialty-trained community and university neurologists. Using rapid videoconferencing technology, the company provides access to neurologists for hospitals that do not have their own on-call neurologist.
Working with these smaller hospitals, a consulting SOC neurologist can view diagnostic test results, including CT scans, and have real-time discussions with ED staff and the patient or family on the prescribed course of treatment, including the possible use of the clot-busting drug tPA. In turn, some patients could be referred to UAB, with its internationally renowned vascular neurologists and neurosurgeons. UAB will be a resource for those hospitals in the event that a patient’s condition warrants specialized stroke management.
“Stroke requires immediate attention; the faster a stroke patient gets to appropriate stroke care the better,” said Bart Kelly, director of the neurosciences service line at UAB.
“The drug tPA, which is the only effective drug for treating ischemic stroke, must be given in the first few hours following the onset of stroke symptoms,” says Andrei Alexandrov, M.D., professor of neurology and director of the UAB Comprehensive Stroke Center. “Unfortunately, only about 3 percent of stroke patients who would benefit from tPA ever receive the drug nationwide. At UAB this proportion of patients treated with tPA is much higher.”
UAB will also work with community hospitals and SOC on continuing medical education in stroke, quality review and awareness efforts in the local community to emphasize that stroke is a true medical emergency.
“Pick up the phone and dial 9-1-1 immediately if you think you or a family member is having a stroke and insist on coming to a hospital known to paramedics to give tPA for stroke.” said Alexandrov. “The landscape for stroke-management in Alabama is improving. We continue to make advances in stroke-awareness, education, prevention and emergency response. UAB is a leader in stroke treatment delivery and research, and we look forward to working with SOC to fill a void by introducing a telemedicine component.”