Mobile Tele-Health Technology for Rural Stroke Care

"Mobile" TeleStroke

Dr. John Falconer – Neurologist Kelowna General Hospital Roberto Trasolini – 2’nd year medical Student UBC SMP + Thanks to: - All the Neurologists and Emergency Room Physicians In Kelowna and the Interior Health Authority - Interior Health Authority – esp. Dr. Robert Halpenny - Interior Health Authority IT – esp. Malcolm Griffin

Mobile Tele-Health for Rural Stroke Care

- 50,000 strokes in Canada each year - Stroke is the third leading cause of death in Canada. - Stroke costs the Canadian economy $3.6 billion a year in physician services, hospital costs, lost wages, and decreased productivity

STROKE

TPA - Clot Busting Drug

• Right kind of Stroke

• CT Scan

• Neurologist Consultation

3 to 4 Hours for "Clot Busting Drug"

TPA Benefit • ~ 10% stroke patients suitable

• 1/3 Appropriate Patients Benefit

• Sometimes Miraculous

• Some dying, 20 minutes later ~ normal

• Some dense hemiplegia, next day mild weakness only

IHA - UBC Mobile Telestroke Pilot Study

• Kelowna Neurologists all supplied with iPads; can see and talk with patient

• 5 Referring Hospital ER's supplied with iPads

• Stroke Patient arrives in ER, option to have Video-Conference with Kelowna Neurologist

• Pilot over 6 months

Castlegar Patient

Trail CT

Kelowna Neurology

Face Time

Current "Telehealth"

$25,000 $25,000

$800 $800

IHA Mobile Telestroke

vs.

Connection KGHN -> LERD/Patient

CELLULAR

CELLULAR

Home or Office

Hospital/ Outside

Date

Hospital

MD’s

Patient

Hear & See Neurologist

Satisfied Need

Improved Care

LEDP

User Friendly

Satisfied Need To Consult

Improved Care

Process Changed

Care

KGHN

User Friendly


Improved Care

Process Changed

Care

MediTech ID

Age Gender Weight

Kg NIHSS EHS

Admit Time Arrival

CT Time

Transferred to another Hospital

FaceTime V-C call

Time

FaceTime V-C call Duration

Data Collection:

MediTech ID

Age Gender Weight

Kg NIHSS EHS Admit Time Arrival

CT Time


FaceTime V-C call

Time


Anonymous Tracking

63

M=F

N/A

MediTech ID

Age Gender Weight


CT Time


FaceTime V-C call

Time


4.64 4/5

4/5

MediTech ID

Age Gender Weight


CT Time


FaceTime V-C call

Time


9:49

11:11

4/25

MediTech ID

Age Gender Weight


CT Time


FaceTime V-C call

Time


10:58

6.8 min

9:49

Patient


Satisfied Need

Improved Care

LEDP

User Friendly


Improved Care

Process Changed

Care

KGHN

User Friendly


Improved Care

Process Changed

Care

1.4 1.4 1.4

1.4 1.4 1.4 1.36 1.4 1.44

Strongly Agree(1) | Agree (2) | Neutral (3) | Disagree (4) | Strongly Disagree (5)

Rural Mobile Telestroke Pilot

LEDP

User Friendly


Improved Care

Process Changed

Care

1.4 1.4 1.4

Patient


Satisfied Need

Improved Care

LEDP

User Friendly


Improved Care

Process Changed

Care

KGHN

User Friendly


Improved Care

Process Changed

Care

1.4 1.4 1.4

1.4 1.4 1.4 1.36 1.4 1.44

Strongly Agree(1) | Agree (2) | Neutral (3) | Disagree (4) | Strongly Disagree (5)

Rural Mobile Telestroke Pilot

Changed Care: 23/25

Rural Mobile Telestroke

– they liked it, but did it matter? More Accurate Dx

Used TPA

Avoid TPA

Transfer

Stroke Mimic

No Change

Accuracy of Diagnosis

Enabled TPA

Avoided TPA

Stroke Mimic

Conclusion:

Conclusion: 1. iPad is a feasible Telehealth Device

2. Used infrequently; High Value when Used

3. Neurologist Driven

4. WiFi Security hampers V-C

5. Cellular V-C effective

Thank you to IHA: • Dr. Robert Halpenny • Mal Griffin CIO • Many others

IHA MedIT Leads the Province In facilitating eHealth

Interior Health Authority "Mobile" Telestroke

"Mobile" TeleStroke

Mobile Tele-Health Technology for Rural Stroke Care

Health & Medicine

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