"Mobile" TeleStroke

- 50,000 strokes in Canada each year

- Stroke is the third leading cause of death in Canada.

- Stroke costs the Canadian economy $3.6 billion a year in

physician services, hospital costs, lost wages, and

decreased productivity

STROKE

TPA - Clot Busting Drug

• Right kind of Stroke

• CT Scan

• Neurologist Consultation

3 to 4 Hours for "Clot Busting Drug"

TPA Benefit

• ~ 10% stroke patients suitable

• 1/3 Appropriate Patients Benefit

• Sometimes Miraculous

• Some dying, 20 minutes later ~ normal

• Some dense hemiplegia, next day mild

weakness only

IHA - UBC Mobile

Telestroke Pilot Study

• Kelowna Neurologists all supplied with iPads;

can see and talk with patient

• 5 Referring Hospital ER's supplied with iPads

IHA - UBC Mobile

Telestroke Pilot Study

• Stroke Patient arrives in ER, option to have

Video-Conference with Kelowna Neurologist

• TPA or non-TPA Stroke patient eligible

• Pilot over 6 months

Castlegar

Patient

Trail

CT

Kelowna

Neurology

Face Time

Current "Telehealth"

$25,000 $25,000

$800 $800

IHA Mobile Telestroke

vs.

Connection KGHN -> LERD/Patient

C

E

L

L

U

L

A

R

C

E

L

L

U

L

A

R

Home or Office

Hospital/

Outside

Date

Hospital

MD’s

Patient

Hear & See

Neurologist

Satisfied

Need

Improved

Care

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

KGHN

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

MediTech

ID

Age Gender Weight

Kg NIHSS

E

H

S

Admit Time

Arrival

CT

Time

Transferred

to another

Hospital

FaceTime

V-C call

Time

FaceTime V-C

call Duration

Data Collection:

MediTech

ID

Age Gender Weight

Kg NIHSS EHS Admit

Time

Arrival

CT

Time

Transferred

to another

Hospital

FaceTime

V-C call

Time

FaceTime V-C

call Duration

Anonymous

Tracking

63

M=F

N/A

MediTech

ID

Age Gender Weight

Kg NIHSS EHS Admit

Time

Arrival

CT

Time

Transferred

to another

Hospital

FaceTime

V-C call

Time

FaceTime V-C

call Duration

4.64 4/5

4/5

MediTech

ID

Age Gender Weight

Kg NIHSS EHS Admit

Time

Arrival

CT

Time

Transferred

to another

Hospital

FaceTime

V-C call

Time

FaceTime V-C

call Duration

9:49

11:11

4/25

MediTech

ID

Age Gender Weight

Kg NIHSS EHS Admit

Time

Arrival

CT

Time

Transferred

to another

Hospital

FaceTime

V-C call

Time

FaceTime V-C

call Duration

10:58

6.8

min

9:49

Trail

Vernon

Nelson

Creston

Grand Forks

Cranbrook

Rural Hospitals Connected With – 86% CT Enabled

Neurologists Using Face Time

WL

JF

SM

DC

DA

14

7

4

0

0

Neurologists Using Face Time

14

7

4

0

0

o My iPad wasn’t

charged

o It was 3:00 am

o No appropriate call

forgot it at home

- Those who didn’t…

Patient

Hear & See

Neurologist

Satisfied

Need

Improved

Care

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

KGHN

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

1.4 1.4 1.4

1.4 1.4 1.4 1.36 1.4 1.44

Strongly Agree(1) | Agree (2) | Neutral (3) | Disagree (4) | Strongly Disagree (5)

Rural Mobile Telestroke Pilot

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

1.4 1.4 1.4

Patient

Hear & See

Neurologist

Satisfied

Need

Improved

Care

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

KGHN

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

1.4 1.4 1.4

1.4 1.4 1.4 1.36 1.4 1.44

Strongly Agree(1) | Agree (2) | Neutral (3) | Disagree (4) | Strongly Disagree (5)

Rural Mobile Telestroke Pilot

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

1.4 1.4 1.4

Patient

Hear & See

Neurologist

Satisfied

Need

Improved

Care

LEDP

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

KGHN

User

Friendly

Satisfied

Need To

Consult

Improved

Care

Process

Changed

Care

1.4 1.4 1.4

1.4 1.4 1.4 1.36 1.4 1.44

Strongly Agree(1) | Agree (2) | Neutral (3) | Disagree (4) | Strongly Disagree (5)

Rural Mobile Telestroke Pilot

Changed Care: 23/25

Rural Mobile Telestroke

– they liked it, but did it matter? More Accurate Dx

Used TPA

Avoid TPA

Transfer

Stroke Mimic

No Change

Accuracy of Diagnosis

Enabled TPA

Avoided TPA

Stroke Mimic

Conclusion:

Conclusion:

1. iPad is a feasible Telehealth Device

2. Used infrequently; High Value when Used

3. Neurologist Driven

4. WiFi Security hampers V-C

5. Cellular V-C effective

Thank you to IHA:

• Dr. Robert Halpenny

• Mal Griffin CIO

• Many others

IHA MedIT Leads the Province

In facilitating eHealth

Interior Health Authority

"Mobile" Telestroke

"Mobile" TeleStroke