New teleneurology medicine program to provide 24-hour emergency services launched

Program will bring 24/7 emergency stroke and neurology critical care to rural and small suburban hospitals in North Carolina and Virginia

Rural and small, suburban hospitals in North Carolina and Virginia can now provide a higher level of emergency stroke and critical neurology care, 24 hours a day, 365 days a year, as part of a new teleneurology medicine program announced Oct. 26, 2009, by Forsyth Medical Center (FMC). The program, coordinated through the Forsyth Stroke & Neurosciences Center, allows medical staff at participating hospitals to rapidly connect with highly trained, board-certified neurologists using videoconferencing technology at the patient's bedside.

Hugh Chatham Memorial Hospital in Elkin, N.C., Brunswick Community Hospital in Supply, N.C., Kernersville Medical Center in Kernersville, N.C., and Twin County Regional Hospital in Galax, Va., are participating in the network. A number of other hospitals will join the network in the future.

"Our program combines the vast resources of FMC's nationally certified, award-winning stroke center with some of the country's leading private practice and academic neuroscience physicians," says Cher- Chase, M.D., medical director of stroke and neurocritical care at Forsyth Medical Center. "We can now quickly bring world-class emergency stroke and critical neurology care to hospitals that may lack 24/7 on-call neurologists or that want to strengthen their current primary stroke care services."

Because of the shortage of experienced, trained neurologists in smaller communities, many stroke victims bypass their local hospitals, causing delay in receiving treatment. Now, they can be treated locally, saving lives and improving the chances for a better recovery.

The new program will link participating community hospitals with FMC and Specialists On Call (SOC), a Joint Commission-accredited organization of board-certified, specialty trained, community and university neurologists. SOC neurologists have a minimum of 10 years in clinical practice and include nationally recognized physicians affiliated with departments of neurology at world-class medical centers, including Brown University, Florida State University College of Medicine and the University of Pennsylvania School Of Medicine. SOC physicians have provided more than 7,000 consults in 2009 for neurological emergencies.

"Sixteen SOC physicians are now affiliated with Forsyth Comprehensive Neurology and have become licensed in North Carolina and credentialed at Forsyth Medical Center," Dr. Chase says. "This allows community hospitals in the Carolinas and Virginia to have access to an expert level of comprehensive stroke and neurological care not available at any single medical center in the country."

How it Works

Rural and small, suburban community hospital emergency department physicians, intensive care unit physicians and hospitalists will be able to have real-time physician-to-physician consultation to quickly determine the best course of treatment for patients requiring emergency or advanced neurological care.

When a potential stroke victim enters the emergency department, the staff will be connected to an on-call expert neurologist and establish a videoconferencing link using a mobile unit that can be brought to the patient's bedside. The consulting neurologist will then be able to view and discuss diagnostic test results, including CT scan images performed at the local hospital. During the consult, physicians, patients and family members will continue to have real-time discussions about diagnostic results, course of treatment and patient response.

A significant advantage of having an experienced critical stroke care neurologist involved is to assist in determining if the clot-busting drug tPA should be part of the treatment. This is important as tPA must be administered within a three-hour window from the onset of the first stroke symptoms.

It will also allow participating network hospitals to provide more advanced stroke care for up to six hours, reducing the need to immediately transfer patients to a comprehensive stroke center such as Forsyth Medical Center for additional care.

"When a person suffers a stroke, 1.9 million nerve cells in the brain die every minute," Dr. Chase explains. "This steady loss of brain cells can often be curtailed through the use of tPA, but determining its appropriate use is best done by trained and experienced stroke and critical care neurologists."

For participating community hospitals, having this level of physician expertise on call will help to save lives and brain function for many patients and may eliminate the need to transport patients to a certified primary stroke center or comprehensive stroke center for further treatment.

Providing support for emergency stroke care is only one component of Forsyth's program, which will also include rapid access to consultation for patients with conditions such as aneurysms, brain tumors, concussions, epilepsy and other conditions that can affect the head and spine. The program will also provide stroke treatment training at participating hospitals and stroke prevention outreach to communities they serve.

Forsyth Medical Center plans to offer its 24-hour emergency teleneurology services to other hospital organizations throughout North Carolina and Virginia.