Telemedicine Myth of the Month
Each month, we’ll discuss a different telemedicine myth and why, based on our experience in the industry, the reality is typically much more nuanced. Check back next month for a new telemedicine myth.
Top Telestroke Myths
Telestroke is one of the most widely used telemedicine applications in terms of both facilities with active programs as well as service line maturity. There are, however, many more hospitals and health systems that are considering or may soon consider implementing a telestroke program. Despite many successful examples to the contrary, persistent myths remain about telestroke.
Telestroke Myth #3: There is no need to invest resources into a robust telestroke solution because videoconferencing is sufficient.
The basis of this myth is the assumption that providing the remote neurologist with a view of the patient and an audio conference dialog is of primary importance in remote stroke consultations. This assumption also downplays the importance of diagnostic tools such as CT images and guided workflow that facilitates collaboration between the specialist and bedside clinician.
The Reality: Videoconferencing on its own is insufficient for stroke consultations, and next-generation telestroke solutions provide enhanced tools and workflow optimized for telestroke, which are unavailable in basic telepresence systems.
Videoconferencing alone is inadequate for a stroke consult. At a minimum, a neurologist also needs a CT scan to differentiate between an ischemic stroke and a hemorrhagic stroke. Additionally, potential treatment options such as tPA are best evaluated in the context of patient vitals, along with information including existing medications, medical history and NIHSS evaluations.
This information is necessary for the thorough evaluation of a stroke patient and his or her potential treatment options, regardless of whether the neurologist is in the ED with the patient or providing a teleconsult.
Next-generation telestroke solutions not only provide this critical information with a single login, but also provide diagnostic enhancements that are simply unavailable in telepresence systems. Diagnostic tools such as the NIH Stroke Scale or modified Rankin scale are built into next-gen telestroke solutions so neurologists can literally perform the same exam they would conduct in person.
An approach that combines videoconferencing and documentation into the EHR system is also insufficient for a telestroke consultation. Simply put, an EHR-based documentation tool is not optimized for the acute care setting or the workflow associated with telestroke. EHR systems are designed for the storage of comprehensive medical records over long periods of time. While many benefits accrue from EHR systems, most physicians do not believe these systems create point-of-care efficiencies or improve the quality of patient care.
By contrast, the documentation tools for next-generation telestroke systems are designed specifically for stroke care. These documentation tools mirror the familiar workflow used to evaluate stroke patients. They encourage collaborative diagnosis between the ED doctor and remote neurologist by enabling both to update the clinical record and view each other’s updates in real time.
Advice: Seek telestroke solutions that offer stroke-specific workflow and are appropriate for the acute care setting. While the technology may be sophisticated, it is critically important that it be easy to use.