The Wake Forest Baptist Telestroke Network, part of our Comprehensive Stroke Center, is focused on reducing death and disability caused by strokes. The Network accomplishes this by partnering with community hospitals to ensure 24-hour access to our acute stroke experts via 2-way live video and audio consultation and image sharing technology. This allows physicians at community hospitals to have immediate access to the latest advancements in stroke care.
About the Wake Forest Baptist Telestroke Network
The Wake Forest Baptist Telestroke Network serves approximately 24 counties in western North Carolina and southern Virginia. More than 1 million adults over the age of 45 live in the area, and the projected growth rate for adults over 45 is nearly 11 percent.
The goal of the network is to bring 24/7 access to expert stroke care to patients in hospitals in smaller communities of the region. Wake Forest Baptist is the base of the network. Community hospitals are a critical component and are considered a network hospital.
Through this network, physicians are able to receive on-demand consultation to help diagnose strokes, develop care plans, and take action if necessary. We provide training to organize services for network hospitals, including helping them achieve designation as a Comprehensive Stroke Center. Our interventional neuro-radiology specialists and neurosurgeons can be rapidly available to care for patients if necessary.
Our stroke specialists, each of whom has completed an additional year of fellowship training in the care of stroke patients or is board certified in vascular neurology, make up the largest stroke team in the region.
How the Telestroke Network Works
Through the Internet, a Wake Forest Baptist stroke expert seated at the InTouch Health control station can simultaneously view electronic patient records and connect to an RP-7 Robot or RP-Lite system located at the network hospital. Under direct control of the physician, the system can move untethered, allowing him or her to freely interact with patients, family members and hospital staff.
After initial treatment, if the patient needs to be transferred, transportation by helicopter is available, as well as preferential bed placement at our nationally-ranked academic medical center.
The following breaks down the process for what happens at the network hospital, as well at Wake Forest Baptist, when a Telestroke consultation is needed.
- Doctor reviews patient’s status, determining need for stroke evaluation
- Telestroke mobile robot unit is moved to patient’s bedside
- Patient and doctor speak directly to the Telestroke doctor
- Telestroke doctor conducts consult examination and evaluation for tPA administration
- If necessary, hospital staff prepares patient for air or ground transport
Wake Forest Baptist
- Provides 24/7 on-call stroke experts with additional training in vascular neurology
- Stroke doctor begins video conferencing and evaluates patient data and CT scan
- Consult exam given via Telestroke system to evaluate presence or severity of stroke
- Consultation with network hospital to determine best treatment plan for patient
Benefit to Network Hospitals
A stroke is a medical emergency. The faster a patient receives proper treatment, the better the chances for recovery. With increased awareness of symptoms, stroke patients are getting to hospitals quicker, and physicians have more treatment options.
“Telestroke has changed the paradigm of treatment,” said Charles H. Tegeler IV, MD, professor of neurology and director of Wake Forest Baptist’s Telestroke Services. “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.”
Our goal is to partner with network hospitals to provide care that is in the best interest of neurology patients and their families. We will work together to determine the best routes of care and strive to keep the care local, including rehabilitation services when possible.
“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.”
Benefits of joining the Telestroke Network include:
- 24/7 bedside access to stroke experts
- Enhancing network hospital’s reputation and building good will in the community
- Joint Commission Comprehensive Stroke Center certification assistance
- Decreasing length of stay in ED
- Potentially reducing physician recruitment and call pay expenses
- Increasing satisfaction among emergency physicians, who may not be comfortable administering tPA
Through the Telestroke Network, our goal is to support our network hospitals in creating a healthier community and stronger financial performance.
Technical Requirements for Hospitals in the Telestroke Network
The Wake Forest Baptist Telestroke Network employs state-of-the-art technologies that are user-friendly, readily available, reliable and secure, resulting in a network that is easy to deploy, operate and maintain.
Equipment and Technology
- Emergency room with an 802.11 wireless Internet access with 600 kbps, lower broadband can be configured with good performance.
- 24 hour laboratory testing capabilities
- Pharmacy that stocks tissue plasminogen activase
- InTouch Health® RP-7® or RP-Lite robotic video conferencing system
- 24 hour CT scanner
- Teleradiology connection, can be provided if not currently available
The Wake Forest Baptist Telestroke Network provides comprehensive education and training to network hospital personnel regarding the specific requirements and needs for a Telestroke patient examination.
Prior to Telestroke Deployment
- Our team and InTouch Health will conduct a technical assessment and, if necessary, make recommendations to ensure that the network hospital will support Telestroke.
- Our team will spend one half to one full day with practicing physicians, nurses and hospital staff to review and practice the acute stroke management protocol.
- Several mock patient consultations via the Telestroke system will be planned to practice quick and accurate activation of the Telestroke system.
- Our team will assist with any additional education and training of network hospital staff.
After Telestroke Deployment
- The Wake Forest Baptist Telestroke team will assist with ongoing education and training of network hospital staff.
- Our team will provide quarterly quality reports and key statistics to the network hospital to continually identify opportunities to improve the care of stroke patients, as well as improve the functionality of the Telestroke system.
About the Comprehensive Stroke Center
Wake Forest Baptist Medical Center is internationally known for pioneering work in stroke treatment, diagnostic technologies and improved outcomes in stroke care.
As a Comprehensive Stroke Center, Wake Forest Baptist uses a multidisciplinary approach that combines the expertise of specialists in neurosurgery, interventional radiology, emergency medicine, neuro-intensive care and neurology.
Our facility includes a designated stroke unit, neuro-critical care unit, and neurosurgical unit designed to meet the needs of patients with ischemic stroke, transient ischemic attack (TIAs), and hemorrhagic stroke.