Kaiser Permanente's 'telestroke' program pays off

Brain imaging

Kaiser Permanente’s telestroke program was first implemented in Southern California Kaiser Permanente medical centers between August 2013 and December 2014. Since then, the program has proven itself by way of an increase in use of a lifesaving clot-dissolving treatment.

The telestroke program brings specialized treatment to patients in hospitals that don’t have a specific in-house stroke neurology and neurological intensive care unit. Instead, images of the patient’s brain are shared with an emergency and remote physician via electronic health record. The neurologist can assess the patient via video tech to determine if the patient is a candidate for tissue plasminogen activator (tPA). This treatment is the only FDA-approved treatment for acute ischemic stroke.

The remote neurologist can sometimes assess the patient before they have even made it to the emergency department via ambulance, Kaiser explained in the announcement.

Since its implementation, tPA use has increased by 73% in patients with acute ischemic stroke, according to a study that was published in The Permanente Journal. According to Kaiser, tPA is often underutilized, as its success depends on how rapidly it can be administered. It needs to be administered within 60 minutes of the onset of stroke symptoms and is more effective the sooner a patient receives it.

"Our findings add to the existing body of evidence supporting the value of telestroke programs for improving tPA administration rates among ischemic stroke patients at hospitals, which may have limited resources or access to neurological expertise," explained Dr. Adam Sharp, study lead author for the Kaiser Permanente Southern California department of research & evaluation, in a release.

The study looked at 2,657 patients at 11 of Kaiser’s medical centers in Southern California. Results found that use of tPA increased from 6.3% among acute ischemic stroke patients to 11% after telestroke implementation and overall bleeding complications were reduced slightly, from 5.1% to 4.9%. Treatment times improved as well, with median time for a patient to receive diagnostic imaging improving from 56 minutes to 44 minutes and time to tPA administration improving from 66 minutes down to 55 minutes.

- here's the press release

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