Telestroke networks can improve bottom line of patients and hospitals

Published on December 18, 2012 at 5:42 AM · No Comments

Telestroke networks that enable the remote and rapid diagnosis and treatment of stroke can improve the bottom line of patients and hospitals, researchers report.

A central hub hospital delivering rapid stroke diagnosis and treatment partnering with typically smaller spoke hospitals in need of those services means more patients recover better and the network - and hospitals - make money, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

"We measure stroke treatment in reduced disability and improved function and we have clear evidence that patients who get timely intervention do best," said Dr. Jeffrey A. Switzer, stroke specialist at the Medical College of Georgia at Georgia Health Sciences University.

"If you are hospital administrator, you may like the idea conceptually but you have to be concerned about the risks of investing up front to do this. This is the first study to show that if it's set up correctly, a telestroke network will more than pay for itself."

Switzer is corresponding author on the study using five years of patient and hospital data from telestroke networks at GHSU and the Mayo Clinic. Researchers plugged the data into a model designed to compare effectiveness and hospital costs with and without a telestroke network. The telestroke model has one hub and seven spokes, the average network size in the United States.

They found that annually with a network:

  • 45 more patients would receive the clot buster tPA, or tissue plasminogen activator, the only Food and Drug Administration-approved stroke drug
  • 20 more patients would receive endovascular therapy such as mechanically removing the clot from a blood vessel
  • Six more patients would be discharged to their home instead of a nursing home
  • The network made nearly $360,000, with each spoke hospital making more than $100,000

Major costs of telestroke networks include technology, technical support, transferring patients and paying physicians to take the extra call, said Switzer. "The question is whether it's in the interest of hospitals to develop networks that set up these telestroke relationships."

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