A Wellington telestroke pilot– offering expert after-hours advice to regional hospitals – has seen a dramatic increase in clot-busting interventions being offered to stroke patients.
The six-month pilot was headed by Wellington Regional Hospital neurologists who provided after-hours stroke advice via a video link to Hawke’s Bay, Palmerston North, Nelson and Wairau hospitals. (It has since been extended to Whanganui and Masterton hospitals.)
The video conferencing technology allowed the Wellington-based experts to provide decision support to less experienced frontline clinicians on whether to offer a stroke patient the clot-busting treatment thrombolysis. Thrombolysis can reverse some of the effects of stroke to patients who meet the criteria, but needs to be given within a matter of hours of the onset of stroke symptoms.
Associate Professor Anna Ranta, a stroke neurologist and the pilot lead, said since it started delivering the telestroke service the level of stroke thrombolysis treatment had raised across the Central Region from 8 per cent to 16 per cent. “The highest regional intervention rate across New Zealand.”
“While all district health boards offer the treatment, the telestroke service ensures all central region DHBs offer a consistent 24/7 service,” said Ranta. “This has been the first such collaboration of treating stroke patients together.”
“Not only has it allowed us to develop strong working relationships with stroke doctors and nurses across the six hospitals involved, it’s also meant there’s no treatment delay for the patient. Patients are able to ask questions and are fully involved with the treatment decision.”
The pilot, which was funded by the Ministry of Health, has since been replicated in the Midland region, and there are plans for telestroke to be implemented across the South Island. A new funding model has also been developed for the service, which allows DHBs to subscribe and pay an annual fee based on their individual population catchment area.
“Telestroke has made a real difference in reducing inequity of access to round-the-clock, high-quality acute stroke care in New Zealand,” said Ranta. “The extension of the service across the country will make a big difference to the treatment and recovery of stroke patients.”