Telestroke thrombolysis is a good example of how the use of ICT in healthcare can significantly improve acute medical care. Specialised stroke units offer the best chances for patients to survive a stroke without or with only minor disabilities. But access to stroke specialists is limited, especially in rural regions.
Patients cannot easily be transferred to specialist stroke units because therapy should start as early as possible. Dr. Tiina Sairanen, neurologist at Helsinki University Central Hospital (HUCH) said that thrombolysis is "the number one evidence-based therapy in stroke", and that "it is most effective if applied during the first ninety minutes after the symptoms have started."
In Finland, the Telestroke Network has been established to improve stroke care in rural hospitals. The HUCH acts as the hub of the network. Neurologists are available there 24 hours a day, seven days a week. In a first step, five smaller hospitals that are up to 800 km away from Helsinki were connected to the HUCH using videoconferencing equipment. Apart from audiovisual consultations, the technology also allows for the transfer of brain CT scans.
Dr. Sairanen presented results of a study that analysed 106 consecutive telestroke consultations within this network. “We performed thrombolysis in 57.5 % of these patients, which is an extraordinarily high rate.” Half of the patients had a favourable long-term outcome, which again is a high percentage. In 6.7% of the patients, intracranial bleedings occurred. “This is not more than we see in our own patients in Helsinki”, said Sairanen.
The network has proven attractive for others as well: two more Finnish hospitals have joined it recently, and another two will join by the end of 2012.
(*) the process of breaking up and dissolving blood clots.