STPH, Ochsner Expand Telemedicine
PARTNERSHIP WITH OCHSNER ALLOWS STPH
TO EXPAND TELEMEDICINE, STROKE CARE
COVINGTON - When St. Tammany Parish Hospital announced a strategic long-term regional partnership with Ochsner Health System, comprehensive neuroscience care, such as stroke care and neurosurgery, was among the top three areas for initial growth.
The treatment of a recent STPH stroke patient underscores how the institutions are using technology and clinical collaboration to enhance their already-excellent stroke programs.
The patient was resting after a successful outpatient procedure when her nurse detected a subtle change in her speech that seemed like something more than drowsiness related to surgical sedation.
That symptom culminated in a first-of-its-kind use of telemedicine equipment that allowed STPH and Ochsner clinicians to successfully collaborate on the patient’s treatment.
Michael Isabelle MD of STPH’s Emergency Department and a team of emergency nurses used mobile telemedicine equipment that gives them around-the-clock, remote access to Ochsner’s stroke specialists.
Speed is critical in treating stroke patients, who lose thousands of irreplaceable brain cells a minute. Clot-busting medicine is highly effective in treating strokes caused by clots that block the flow of blood to the brain, but Tissue Plasminogen Activator, or tPA, can cause additional brain injury under certain circumstances.
The STPH team faced additional complexities in this patient’s care. She had been in surgery less than an hour earlier, meaning potential additional risk to the use of tPA, and the team had never treated a stroke patient in the hospital’s surgery recovery area.
Dr. Isabelle did not want to lose time by moving the patient to the Emergency Department.
“I needed to do there what I usually do in the emergency room,” Dr. Isabelle said.
That included using telemedicine equipment to consult with an Ochsner stroke specialist. Live, two-way transmissions allow Ochsner vascular neurologists to see and hear the patient, information that is critical to determining the size and location of a brain lesion and the best way to treat it.
“It allows me to treat the patient wherever they are,” said Gabriel Vidal MD, a vascular neurologist with Ochsner’s TeleStroke program. “With telestroke, the specialized physicians can share their expertise remotely, allowing for the patient to be treated without delay, and, in most cases, prior to or without the need to be transferred.”
TeleStroke consultations can allow patients to remain at STPH for treatment. In this more complex case, however, the patient was airlifted to Ochsner Medical Center in New Orleans, where she was treated successfully for stroke.
Brain scans and other information the STPH team sent to Ochsner allowed for faster treatment after the transfer.
“The boxes were checked by the time she got there,” said Mary Krentel RN, PACU department head at STPH.
The partnership will only enhance a stroke protocol for non-emergency patients that STPH was already developing at the time of last year’s unique TeleStroke consultation.
The protocol includes informing all non-emergency employees about the signs of stroke, said Lisa Sharp RN, Emergency Department nurse supervisor.
“This experience gave us insight into developing a protocol that has shaved minutes off the (treatment) process,” Sharp said.