A few weeks late in the posting, but relevant to the telemedicine collaboration issues raised by Professor James Barlow’s report from the ATA 2013: Over the last 18 months a telemedicine system set up to help stroke patients by the NHS Cumbria & Lancashire Cardiac and Stroke Network (CSNLC) has provided 24-hour access to thrombolysis treatment from remote specialists. The telestroke network serves eight hospitals that serve a population of 2.2 million. NHS telemedicine system for strokes hailed as a success (ComputerWorld) Heads-up thanks to Alistair Hodgson.
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The telestroke session at the ATA Conference reported on the San Diego / UCD programme, with some interesting points about the short and longer term benefits in terms of better access to tPA (the clot busting drug with a 3-4 hour window post stroke), reduced patient transfers to a hospital that administers it, and financial savings to the healthcare payers ($44,000 – $85,000 lifetime savings). It also found that in ‘hub and spoke’ telestroke systems (with the hub providing expertise and spokes linked in via telemedicine), there are differences between each side in benefits and costs – spoke hospitals can pay high contract costs to the hubs to be part of the network and hubs may still get the minor cases, as the emergency services still bypass the spokes, thinking they’re not equipped to deal with stroke.
For initial findings from a UK-based study on the costs and benefits of telestroke, see “Addressing the barriers”, Health Services Journal, 4 October 2012.
(or http://www.james-barlow.com/blogs/read_69746/addressing-the-barriers.html#.UYmAroKXKfU)