Telestroke networks that enable the remote and rapid diagnosis and treatment of stroke can improve the bottom line of patients and hospitals, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
A central hub hospital delivering rapid stroke diagnosis and treatment, partnering with typically smaller spoke hospitals in need of those services, means more patients recover and the network, and hospitals, make money, according to the study.
“We measure stroke treatment in reduced disability and improved function and we have clear evidence that patients who get timely intervention do best,” said Dr. Jeffrey A. Switzer, stroke specialist at the Medical College of Georgia at Georgia Health Sciences (GHSU) University in Augusta, Ga. He said this is the first study to demonstrate that a telestroke network will pay for itself if it is set up properly.
The study used five years of patient and hospital data from telestroke networks at GHSU and the Mayo Clinic. Researchers plugged information into the model designed to compare effectiveness and hospital costs with and without a telestroke network. The telestroke model has one hub and seven spokes, which is the average network size in the U.S.
They found that annually with a network:
- 45 more patients would receive the clot buster tPA, or tissue plasminogen activator.
- 20 more patients would receive endovascular therapy such as mechanically removing the clot from a blood vessel.
- Six more patients would be discharged to their home instead of a nursing home.
- The network made nearly $360,000 with each spoke hospital making more than $100,000.
The study also notes that major costs of telestroke networks include technology, technical support, transferring patients and paying physicians, Switzer said. It suggests that it is in the interest of hospitals to develop networks that set up these telestroke networks, he said. The study supports a model where large, hub hospitals such as GHS Medical Center pay for equipment and other costs smaller hospitals incur using their network. In the majority of cases, patients are seen via the network by stroke specialists in Augusta, and eligible patients are given tPA at the spoke hospital, then are transported to GHS Health System for follow-up care.