telestroke alaska evidence based care across the great frontier mic... · 2014-04-09 · • define...
TRANSCRIPT
![Page 1: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/1.jpg)
Telestroke Alaska Evidence Based Care Across the Great Frontier
Presented by Dr. Christie Artuso Director, Neuroscience Services Providence Alaska Medical Center
1
![Page 2: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/2.jpg)
2
![Page 3: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/3.jpg)
Financial Disclosures
• I am a speaker for Genentech through the Activase® Speaker’s Bureau.
• I am a faculty member at the University of Phoenix facilitating graduate and undergraduate coursework in the Healthcare Sciences Division.
• I have no financial disclosures related to this presentation for the Northwest Regional Telehealth Resource Center
3
![Page 4: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/4.jpg)
Learning Outcomes
• Define telemedicine as a technology used to deliver evidence-based care for patients with an acute focal neurologic deficit.
• Identify three outcomes associated with the use of telemedicine to deliver care in rural settings
• Identify three challenges faced when initiating a telemedicine program for both hub (central support) and spoke (recipient) of services
4
![Page 5: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/5.jpg)
History of Technology……
Years it took to reach a market audience of 50 million: Radio – 38 years……….. Television – 13 years……….. Internet – 4 years………. Ipod – 3 years ………… Facebook – 2 years…….. 5
![Page 6: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/6.jpg)
The Growth of Technology…..
The number of internet devices in 1984 was about 1,000…….. The number of internet devices in 1994 was about 1,000,000………… The number of internet devices in 2008 was about 1,000,000,000……….. According to Forbes (2012) – 8.7 billion
6
![Page 7: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/7.jpg)
The Future of Healthcare?
Nationally, the top ten “In-demand” jobs in 2010 did not exist in 2004…………
– We are currently preparing children for jobs that don’t yet exist
– Using technologies that have yet to be invented
– In order to solve problems that we don’t yet know about………..
7
![Page 8: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/8.jpg)
Technology’s Role………..
Technology continues to advance and facilitate
improved quality in the delivery of healthcare in a
dynamic and complex environment.
8
![Page 9: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/9.jpg)
Telemedicine – defined….
The use of telecommunication and information technology to medical
information and services
Store and forward Remote monitoring
Real-time interactive (video/audio)
9
![Page 10: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/10.jpg)
Clinical Transformation
• Mobile technologies • Mature electronic health records [EHR] • Clinical decision support systems
– Continuous telemedicine / telehealth monitoring
• Shortages of medical specialists • Increased complexity of care as
population ages 10
![Page 11: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/11.jpg)
Why Stroke? “Telestroke”
• 2005 – American Stroke Association developed Stroke Systems of Care emphasizing ‘linkages’ rather than ‘silos’ – Coordinated approach – Improve access to highly skilled care & services
• 30% incidence of mis-diagnosis?
– Implement latest evidence-based guidelines – Early intervention
11
![Page 12: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/12.jpg)
Why Alaska? • 586,412 square miles – distance, cost of transport
• Geographic barriers, extreme weather, vast distances
• Population 722,718 (40% in Anchorage)
• 31 healthcare facilities [3 largest in Anchorage] ; 11 community
hospitals; 13 critical access hospitals; 7 specialty or military hospitals
• 25% of Alaskans live in communities of < 1000 people
• 75% Alaskan communities not connected by roads to a hospital
12
![Page 13: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/13.jpg)
Understanding Alaska….
13
![Page 14: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/14.jpg)
Geographic Penalties
• The quality of stroke care is dependent upon the hospital that you go to
• If you live in a rural area or ‘underserved acute stroke care’ area you will NEVER receive the only FDA approved pharmaceutical agent for treating stroke
• There is a GEOGRAPHIC penalty associated with stroke outcomes………..
14
![Page 15: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/15.jpg)
Why Stroke in Alaska?
• Stroke death rate is 6% higher than national averages
• National death rate is decreasing yet the Alaska death rate stays the same
• Higher smoking population @ 22% • Higher overweight / obesity rate @ 63% • Higher rate of elevated cholesterol @ 31%
15
![Page 16: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/16.jpg)
Barriers associated with Telemedicine?
• Defining the specialty • Licensure and liability • Developing policies recognizing privacy and
security • Simplifying the process (actual consult) • Sustainability – financial models
16
![Page 17: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/17.jpg)
Advantages
• Access to care – Decreased transportation costs – Improved care decisions
• Access to specialists – E-consultation / telestroke / teletrauma / telepsychiatry
• Improved quality – improved patient outcomes – Monitoring – E-consultation with recommendation
• Education and training – Access to conferences / expert consultation
17
![Page 18: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/18.jpg)
Outcomes?
• End 2007 – over 12 telestroke programs in Europe – 18 Hub hospitals & 77 spoke hospitals – 20,000 patients evaluated – 2200 telestroke consults per year – 18% systemic thrombolysis
• 2006 – World Health Organization Helsingborg Declaration on European Stroke Strategies • Access to continuum of care • Acute stroke units • Rehabilitation • Secondary prevention
18
![Page 19: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/19.jpg)
Disadvantages
• Lack of resources – High infrastructure costs – Rapid evolution of technology – Licensure / credentialing
• Reliability – Changing infrastructure and technology
• Rural communities – Available bandwidth
• Trust / distrust • Perception of concept
– Responsibility vs. accountability – Legal limitations
19
![Page 20: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/20.jpg)
Project Framework:
1. What are the essential components of a state-wide Stroke Center of Excellence?
2. What are the essential components of a telemedicine stroke program?
3. Which hospitals in the State of Alaska have the capability to transmit and receive the internet signals necessary for remote telemedicine support?
4. What hardware and software requirements are necessary?
5. What financial support will be required? 20
![Page 21: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/21.jpg)
What are the essential components of a state-wide Stroke Center of Excellence?
• Provision of full range of services for all or most of
the population in a community • Support for evidence-based care • Clinical consultation for evaluation, triage and
transfer • Provision of required diagnostic tests and treatment • Public education
– Risk factors – Primary prevention
21
![Page 22: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/22.jpg)
What are the essential components of a telemedicine stroke program?
• Resources to support infrastructure • Two way audio-video with reliable
connectivity • 24 hour qualified physician (specialist)
support at the Hub • CT scan at spoke (based on hub / spoke
model) • Appropriate provider(s) / telepresenter
at spoke 22
![Page 23: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/23.jpg)
Current Applications Hub and Spoke Model of Care……
23
![Page 24: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/24.jpg)
Which hospitals in the State of Alaska have the capability to transmit and receive the internet signals necessary for remote telemedicine support? • Analysis of hospitals throughout the
State of Alaska asking the following: – Location – Internet access / type – DICOM Compatible CT Scanner – Number of inpatient beds – Estimated emergency department visits per
year – Approximate number of patients with stroke
per year (based on national statistics)
24
![Page 25: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/25.jpg)
Primary Spoke Hospitals
• Bartlett Regional Hospital – Juneau, AK [55 beds]
• Providence Kodiak Island Medical Center – Kodiak Island, AK [CAH - 22 beds]
• Providence Seward Medical and Care Center – Seward, AK [CAH - 12 beds]
• Central Peninsula General Hospital – Soldotna, AK [70 beds]
• Providence Valdez Medical Center – Valdez, AK • Providence Alaska Medical Center – Anchorage,
AK (Hub) [CAH – 4 beds]
25
![Page 26: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/26.jpg)
26
![Page 27: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/27.jpg)
What hardware and software requirements are necessary? • Type of internet connection – wireless vs.
wired? • High definition camera with accessible software • Laptop vs. mobile computer station • Tech support • Electronic records • DICOM image sharing
– Remote – PACS
27
![Page 28: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/28.jpg)
Infrastructure?
• Fiber Optic Lines connecting some communities
• Wireless / web-based access in towns – often DSL or dial-up
• ? Bandwidth • Portable vs. wired? • Technical support? • Travel and education? • Receptiveness
28
![Page 29: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/29.jpg)
Options
• eICU – in process – not available yet • Wireless cart (REACH Health, Inc.) • Robot (RP-7) – In Touch • PolyCom / Global Med – hardware only • Homegrown?
29
![Page 30: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/30.jpg)
What financial support will be required?
• Cost of technology and connectivity • Costs of education and training • Costs associated with hardware
maintenance and replacement • Estimated cost for a three-year
program launch in Alaska ~ $995,000 not including physician fees, patient transport or direct medical costs.
30
![Page 31: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/31.jpg)
Financial Planning
“You may not get what you want…… but often – you get what you measure!”
• Revenue model
– Show clear revenue management • Cost saving model
– Show the benchmark and a method to clearly measure the savings
• Strategic model – Show a way to measure strategic contribution
31
![Page 32: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/32.jpg)
Current Technologies
32
![Page 33: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/33.jpg)
Technology’s Impact on the Healthcare System…………….
• Clinical information systems [Electronic Medical Records]
• Computer-chip–based clinical monitoring devices
• Advanced applications with remote, wired and wireless communication devices [telemedicine; eICU]
• Clinical decision support software [ImPACT] [eICU] 33
![Page 34: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/34.jpg)
Implications
• Impact on nursing / medical practice – Change in ‘how’ we deliver medical care
• Change in ‘what’ we expect from the healthcare system
• Changes in community perceptions • Changes in provider / nurse / patient
relationship
34
![Page 35: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/35.jpg)
Developing a Program
• Establishing the vision and align with organization’s vision and mission
• Assess the community(ies) [gather data] • Define program objectives
– Survey infrastructure – Identify needs ($$$$, technology, support)
• Develop success metrics • Measure outcomes
35
![Page 36: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/36.jpg)
Establishing a Vision
Critical Questions • Where do you want to go? • How will the ‘journey’ affect your objectives? • How is your vision for the telemedicine program
aligned with your organization’s overall vision? • Is your program objective the same as the
organization’s objective for the program?
36
![Page 37: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/37.jpg)
Vision
Providence Health & Services, Alaska As People of Providence we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Neuroscience Service Line
Recognized as Alaska’s premier Neuroscience Center of Excellence providing collaborative services designed to meet
the needs of the state.
Telestroke Program To provide collaborative evidence-based stroke care that meets the
needs of Alaskans 37
![Page 38: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/38.jpg)
Program Objectives
• Identify 7 potential ‘spoke’ sites in Alaska • Build relationships with staff / leaders in
those organizations • Implement telemedicine (stroke) at 7 sites • Maintain robust support • Identify subsequent sites for implementation • Reevaluate utilization and cost at 24 months • Develop ongoing plan for additional
telemedicine utilization / implementation 38
![Page 39: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/39.jpg)
Assessing the Community
• What needs would the program meet in the community?
• What services would be provided? • Who would use the service? • What technology is available? • What type of connectivity would be effective and
reliable?
39
![Page 40: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/40.jpg)
Impact on Providers and Nursing
Plan and Assure Effective Training
• Workflow • Delivery of patient care • Education • Expectations • Are you the champion?
40
![Page 41: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/41.jpg)
Impact on Patient Outcomes
• Ask appropriate questions – What were the objectives of the program – Did the program develop the infrastructure
necessary to achieve the goals – Was appropriate education provided – What outcomes are expected – How will you measure the outcomes
41
![Page 42: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/42.jpg)
Steps to Success
• Clearly define the objectives of the program • Align program objectives with organization’s
objectives • Outline the results / outcomes that you hope to
accomplish – Short and long term goals with metrics
• Maximize utilization – Frequent use = competency
42
![Page 43: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/43.jpg)
43
![Page 44: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/44.jpg)
HUB - Challenges
• Relationships? • Infrastructure
– IT resources – Biomed resources – Partnerships with telecommunications companies
• Education • Alignment / support • Troubleshooting
44
![Page 45: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/45.jpg)
SPOKE - Challenges
• Trust - distrust • Alignment / support • Education • Frequency of use • Troubleshooting • Infrastructure
– IT Resources – Biomed resources
45
![Page 46: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/46.jpg)
Outcomes?
• Successful implementation in 6 locations • Continued increase in referrals from these sites • Decreased unnecessary transportation • Improved tPA treatment in State of Alaska to 4.7
percent (national average 2-3%) • Improved identification of stroke at spoke
hospitals • Implemented eICU at 2 sites
46
![Page 47: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/47.jpg)
Future strategies?
• Alaska Collaborative for Telehealth and Telemedicine (ACTT)
• Alaska region initiative related to telehealth / telemedicine
• Providence Health Services system wide initiative related to outreach with subdivision for telehealth / telemedicine
• Robust evaluation of systems, reimbursement, infrastructure, resources, community needs
47
![Page 48: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/48.jpg)
Summary………
Telemedicine will be a rapidly growing strategy for the delivery of healthcare throughout the United
States and global communities. Through technology, access to specialized and acute care
services will improve, the overall health of communities will improve and the way we deliver
healthcare will change.
48
![Page 49: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/49.jpg)
Questions?
Dr. Christie Artuso Director, Neuroscience Services
Providence Alaska Medical Center (907) 212-3138
49
![Page 50: Telestroke Alaska Evidence Based Care Across the Great Frontier Mic... · 2014-04-09 · • Define telemedicine as a technology used to deliver evidence-based care for patients with](https://reader034.vdocument.in/reader034/viewer/2022050420/5f8f545f7275c37cdb2e4ee0/html5/thumbnails/50.jpg)
50