One Day After Launch, Telestroke to the Rescue

Helen Jewett became the first Kansas patient
to benefit from telestroke services at Mercy.

At age 89, Helen Jewett will tell you she has experienced a long list of ailments – from heart trouble to a bad back - and seemingly has endured every medical test, scan and procedure imaginable. But recently, she test drove a brand new diagnostic technology at Mercy Hospital Independence.

Jewett became the first Independence, Kan., area patient to experience telestroke services, a telemedicine technology that connects suspected stroke patients in the Mercy emergency room with highly specialized neurologists states away, via a sophisticated audio/video link.
 
“It was amazing,” Jewett said. “The doctor could see me and talk to me, I could see him, and he examined me right through the computer.”
 
Telestroke went live at noon Aug. 29 in Independence, and later that afternoon, a story and photo about the new service appeared on the front page of the local newspaper.
 
Jewett, who lives in Cherryvale, Kan., read about the service, and because she had been having various “stroke like” symptoms herself for several months, the story piqued her interest.
 
“I thought, ‘this might be for me,’” she said.
 
Little did she expect, though, that she would get to experience the new service firsthand the very next day.
 
Earlier in the week, Jewett had noticed weakness and numbness in her arm, and a few days later, her right leg began to “feel funny” and she couldn’t raise it. Considering the previous symptoms she had experienced, she made the decision that she needed to go to the hospital.
 
Her son-in-law made the 911 call, and Emergency Medical Services delivered Jewett to Mercy ER. There, she met Dr. Garcia Rivera, a neuro-stroke specialist, “face to screen” via a telemedicine connection with his office in Fla. Jewett became the first Mercy Hospital Independence patient to experience a telestroke exam, during which Rivera directed her to raise her legs and arms, one by one, to touch her nose, etc., as he observed through the high-resolution video connection.
 
Having just “switched on” this new service the day before, training and support co-workers from Mercy’s SafeWatch telemedicine team in St. Louis were still on site in the ER when Jewett arrived, and they supported the local staff through this first experience.
 
“The process went like clockwork,” said Wendy Deibert, Mercy SafeWatch executive director of telemedicine services and operations. “Patti (Doncouse, ER director in Independence) prepared her team well and they met and exceeded all the guidelines. The patient and the family were very accepting of the new technology and (the physician). She was also excited to learn she was the first patient to receive the service.”
 
Telestroke services are gradually rolling out to emergency departments in Mercy facilities across Kan., Okla., Ark., and Mo., utilizing contracted neurologists who specialize exclusively in stroke care and help fill a gap in communities where specialty physicians are in short supply.
 
The special audio and video equipment used, along with electronic transmission of diagnostic images from the hospital to the neurologist, allows for the entire process of exam, diagnosis and treatment (if appropriate with the clot-busting drug tPA) to be completed within 60 minutes or less.
 
“In the case of a stroke, when every second counts and can mean brain tissue saved or lost, lives spared or lost, this advancement in our technology can make a world of difference for our patients and their families,” said Doncouse.
 
And not only is the new technology serving stroke patients in the ER, but the service also is available when needed for consultations on other neurological conditions, Doncouse explained. In fact, she said, on “day three” of the telestroke system being live in Independence, local physicians and nursing staff arranged a telemedicine neuro consult with a specialist for another patient who had experienced a new seizure disorder and had a suspected brain tumor.
 
“The possibilities really are endless for how we can use telemedicine to provide better and expanded care for our patients here in our small town,” Doncouse said.
 
And as for telestroke patient Jewett, her possibilities are endless as well, thanks to a diagnosis of minor TIA’s – mini-strokes, not a full-blown stroke event – and no significant deficits in function, allowing her to return home to her normal activities.
 
“I’m only 89,” she joked.  “I’m supposed to be in my golden years!”
 
Mercy is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 31 hospitals, more than 300 outpatient facilities, 38,000 co-workers and 1,700 integrated physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. For more about Mercy, visit www.mercy.net.
 
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