Telemedicine can be used for accurate diagnosis of strok...( nce the onset of the stroke usingthes...),Health

nce the onset of the stroke, using these medications can cause more harm than good, possibly even killing the patient. Some patient may require that medications be injected directly to the site of the clot, which would require their being transferred to a specialized stroke center. But if patients are good candidates for intravenous thrombolytic therapy, speedy treatment is essential and should be administered wherever the patient is.

Because physicians with the expertise to determine the best treatment options for stroke patients are primarily located in tertiary care hospitals, telemedicine - the exchange of data and information via electronic means to facilitate diagnosis and treatment - seems a logical way to bring that expertise into community hospitals. Indeed, Schwamm explains, that is already happening in a very low-tech fashion. "When I get a telephone call or faxes from a colleague seeking advice about how to treat a stroke patient that can't get to the MGH fast enough, that is telemedicine at its most basic level. How much better would it be if we could use the kinds of communication technologies now available to let physicians in my position actually see the patients, review their symptoms and, ideally, look at high-quality images taken on site?"

The current study was designed to see whether an established assessment of stroke symptoms could be performed through a telemedicine link as accurately as at the bedside. In order not to compromise the diagnosis of patients with acute stroke, the study enrolled 20 patients recovering from ischemic strokes - those caused by blockage of a blood vessel - at the MGH or Spaulding Rehabilitation Hospital. Each patient was examined twice using the standard National Institutes of Health Stroke Scale (NIHSS). In one instance, the patient was examined by a neurologist at the bedside. The other examination was performed by a neurologist communicating with the patient and a bedside nurse via personal compute
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Contact: Susan McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
8-Oct-1999

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