Device allows for remote stroke diagnosis
Link: http://www.rockymountainnews.com/drmn/local/article/0,1299,DRMN_15_4441319,00.html
By Bill Scanlon, Rocky Mountain News February 4, 2006
A new camera system will allow neurologists in Denver to zoom in on the faces and limbs of patients in outlying Colorado hospitals to determine whether they've had a stroke. The system could save lives because people lose 1.9 million brain cells every minute during a stroke, so the sooner there is a correct diagnosis, the sooner anti-clogging medication can be given, neurologists say.
The Colorado Digital Online Consultant, or CO-DOC, is coordinated by the Colorado Neurological Institute, a nonprofit organization of neurologists that applies for grants and advocates for better access to neurological treatment. Program partners are Swedish Medical Center in Englewood and Blue Sky Neurology.
It soon will be operating between metro Denver and the Vail Valley Medical Center. Swedish and CNI have applied for a state grant so remote machines can be installed elsewhere in Colorado.
"We can actually operate it from anywhere that has Internet access - the home, the office or at Swedish," said Dr. Chris Fanale of CNI.
Here's how the system works:
A patient checks in to a clinic or emergency room of a small hospital with symptoms that may or may not indicate a stroke.
Doctors and nurses who are not experts in neurology may be reluctant to jump to a conclusion because the best anti-clogging medication, TPA, has dangerous side effects that can include fatal bleeding.
So the hospital or clinic calls Swedish Medical Center or the neurologist on duty.
The neurologist plugs into a laptop with special software. A small Web camera is pointed at the doctor's face. On the other end, a larger camera is pointed at the patient's bed. The system allows patient and doctor to see and talk to each other in real time.
"I can zoom in on the face, the arm, wherever I need to," Fanale said.
"We'll be mostly looking at the face, testing their language function and their ability to move their arms and legs."
Using the NIH Stroke Scale, the neurologist might also ask the patient to hold an arm out at a 45-degree angle for 10 seconds.
"Does the arm fall down? How quickly? We give them a number score" based on how well they can do tasks, Fanale said.
When a patient suffers a stroke, "time is absolutely critical," said Fanale, the physician coordinator for CO-DOC.
"This technology makes it so I'm almost literally in the room next to the patient. I can now 'be' at a hospital 100 miles away in a matter of minutes."
There are only a handful of such systems around the nation, Fanale said.
"This is absolutely the first telemedicine system this sophisticated in Colorado."
A stroke happens when a clot blocks blood from flowing to the brain, and causes a sudden onset of symptoms such as slurred speech, numbness and difficulty understanding things.
About 7,000 Coloradans a year experience a significant stroke, and many of them live far from a comprehensive hospital that can provide anti-clogging medication and deliver round-the-clock intensive care.
Vail Valley is the first outlying hospital in Colorado to partner with Swedish, thanks to a $17,500 donation by Doug Tisdale of Vail.
"My wife, Patricia, died of a stroke two years ago," said Tisdale, an attorney. "In her memory, I want to help ensure any stroke victim, regardless of where they are, can have access to every resource available to survive a stroke."
Vail Valley contributed another $20,000 to complete the purchase and installation of the remote machine.