Telestroke Program Saves Lives

Each year, the medical staff at the Veterans Administration diagnose approximately 4,500 veterans with an Acute Ischemic Stroke (AIS) every year. Stroke is the fifth leading cause of death in the U.S and the leading cause of serious long term disability.

The VA’s National Telestroke Program (NTSP) has a virtual “hub” of VA stroke neurologists across participating in a 24/7/365 call schedule to provide coverage to participating facilities. Dr. Sharyl Martini, NTSP Medical Director, reports that the program has 22 neurologists covering telestroke services for 40 VA facilities. The VA forecasts that an additional 20 facilities will be added annually from FY 2021 through FY 2023.

When a veteran with acute stroke symptoms presents at a VA facility, front-line staff use a mobile device to videoconference with the telestroke neurologist, the patient is examined, and then the medical record and CT images are reviewed by the neurologist.

At this point, the neurologist will advise the local treating physician of the diagnosis and recommend treatment. The staff enters the recommendation in the patient’s record and the local provider then executes the recommendations.

The team also uses standardized patients in simulation scenarios involving a patient presenting with stoke symptoms, The Simulation Learning Education and Research Network (SimLEARN RN) Facility supports the program.

Each simulation event involves mobile technology and simulated waveforms on actual patient monitors to increase simulation fidelity. The staff follows the patient through the initial diagnosis, communicates with the telestroke neurologist, on the CT scan, and then administers the medication.

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