In the U.S., the 2015 rate of stroke incidence was just under 800,000 people a year. A particularly disturbing contribution to this statistic is the increasing number of strokes among those aged 50 to 55, which has resulted in a corresponding increase in hospitalizations.
With these changes, stroke is an increasingly important topic of concern for hospitals today as they focus on population health. One way that providers are improving care is to literally bring the hospital to the patient in a mobile stroke unit (MSU).
“In our region, we find that people are developing strokes … at a younger age. [W]e thought it was the best approach to deploy a mobile stroke unit that has the capability of reducing the amount of time that it takes between when the patient experiences symptoms to the time we can actually deliver treatment to the patient, and hopefully significantly impact outcomes,” said Imran Andrabi, president and CEO of Mercy Health Toledo in a recent issue of Hospitals and Health Networks.
When “time is brain,” stroke victims need fast treatment
Every minute a stroke victim goes without treatment, 1.9 million neurons are lost. In the event of an ischemic stroke, the administration of intravenous tissue plasminogen activator, tPA, within three hours of a stroke’s onset of symptoms will dissolve the clot, restoring blood flow to the brain in time to save those neurons. The challenge for providers is getting tPA to patients in time to make a difference in outcomes, while not administering tPA in situations that might be dangerous such as a hemorrhagic stroke.
MSUs provide the mechanism for getting tPA to stroke victims by linking patients from where they are with stroke neurologists. MSUs include mobile blood labs, head-only CT scanners and telecommunications technology.
Through a telecommunications connection, the EMTs in the MSU can communicate immediately with the neurologist who can order a CT right away decreasing the time to order a CT significantly. Then the EMTs perform the CT in the MSU right at the patient’s pick up location and send it on to the stroke neurologist, who diagnoses and orders treatment.
Time is brain and time is money
One of the primary challenges keeping hospitals and health systems from implementing MSUs across the country is cost. As reported in Modern Healthcare, the annual cost to support an MSU, excluding initial capital investment, is about $1.65 million USD per year. This funding covers the cost for the critical-care nurse, CT technologist, paramedic and driver team that goes out with the MSU as well as the on-call stroke neurologist.
As noted above, MSUs improve two critical metrics in stroke care: time to ordering a CT and time to performing at CT. There is a third metric, time to read CT and diagnose, that is dependent upon the availability and location of the stroke neurologist.
While tethering a stroke neurologist to a PACS workstation would guarantee an immediate read of an incoming scan from an MSU, it is a unrealistic and cost-prohibitive solution. Providing on-call stroke neurologists anytime, anywhere access to diagnostic quality images with an enterprise image viewer, such as ResolutionMD, can help solve this problem.
ResolutionMD runs on desktops, laptops, tablets and smartphones, providing clinicians with multiple options for accessing images through an image viewer with full accreditation for diagnosis. With this flexibility, hospitals and health systems can improve the third metric of time to CT reading and diagnosis by providing on-call neurologists with immediate access to patient images from any location on any platform.