Improving Access to Care for Rural Stroke Patients

Stroke is a major cause of death and disability in the southeastern United States. While leading institutions like Wake Forest Baptist Medical Center provide exceptional inpatient care, oftentimes patients in rural areas don’t have access to much needed care. Stroke clinicians, led by Charles H. Tegeler IV, MD, professor of neurology and director of Wake Forest Baptist’s Telestroke Services, are now providing this access to rural areas through the Telestroke Network.

Tegeler and his colleagues are available 24 hours a day, 7 days a week, for patients in five rural hospitals in western North Carolina. When paged, the neurologist on call provides expert consultation via a robot that enables viewing, communicating with and assessing the patient.

“Telestroke has changed the paradigm of treatment,” Tegeler said. “We’re now able to interact with patients and physicians at rural hospitals and provide an informed consultation and expert recommendations for treatment in real time.”

Only about three percent of patients seen for stroke nationwide receive tPA intravenously. Of the patients seen remotely by Wake Forest Baptist neurologists, approximately one quarter have  received tPA. 

“Before our telestroke service, these patients may have missed the opportunity for a treatment that has been shown to improve outcomes after stroke,” Tegeler said. “Providing them with access to tPA treatment for acute stroke—that they might not have received otherwise—has the potential to dramatically improve their functional outcomes.”