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Kaiser Permanente's telestroke program is speeding up treatment
Time to tPA administration reduced from 66 to 55 minutes
After Kaiser Permanente started its telestroke program, use of clot-dissolving treatment on patients with acute ischemic stroke rose by 73 percent, according to a new study published in The Permanente Journal.
Tissue plasminogen activator (tPA) is the only treatment for acute ischemic stroke that is approved by the FDA. In order for it to be effective, it has to be administered within 60 minutes of the onset of the stroke symptoms.
The treatment is largely underutilized because the clinicians aren’t able to get the patient to the hospital in time for the neurologist to determine if they are a candidate. The telestroke program overcomes that by enabling the neurologist to remotely evaluate the patient.
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For the study, the researchers assessed 2,657 patients at 11 Kaiser Permanente medical centers in Southern California that implemented a telestroke program between August 2013 and December 2014.
Before the programs were initiated, eight of those centers were very unlikely to administer tPA to ischemic stroke patients compared to the hospital with the largest volume of stroke patients. But after the programs were implemented, all of the facilities were at least as likely as that hospital to administer tPA, and one even performed better.
Bleeding complications did not rise and were overall slightly lower after the program was implemented. In addition, the median time for a patient to receive diagnostic imaging was reduced from 56 to 44 minutes and the time to tPA administration for candidates was reduced from 66 to 55 minutes.
The use of mobile stroke units has surged in the U.S. The global market for mobile stroke units is expected to reach $9.4 million by 2020, according to a new report by Grand View Research Inc.
In February, Mercy St. Vincent Medical Center equipped a mobile stroke unit with Samsung NeuroLogica’s CereTom CT and in March, the University of Tennessee deployed a Siemens SOMATOM Scope CT mobile stroke unit.
