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The Arizona Telemedicine Program Blog

telestroke computer

Jack Porter isn’t one to admit he had a stroke three years ago.

“I didn’t have a stroke,” he will tell you. “I had a stroke of luck.”

Porter, who has lived in Bisbee since he was two weeks old, was unable to talk or move his left leg or left arm when he arrived at Copper Queen Community Hospital’s emergency room. Daniel Roe, MD, chief medical officer and director of emergency services and telemedicine at Copper Queen, ordered a CT scan that showed a clot forming on the right side of Porter’s brain.

But there was no neurologist at the hospital to advise what to do next. And that’s what led to Porter’s “stroke of luck.”

Telemedicine and a POT (plain old telephone)

"In terms of disease management,” stated Dr. Devi Shetty in Sanjit Bagchi’s article Telemedicine in Rural India, “there is [a] 99% possibility that the person who is unwell does not require [an] operation. If you don't operate you don't need to touch the patient. And if you don't need to touch the patient, you don't need to be there. You can be anywhere, since the decision on healthcare management is based on history and interpretation of images and chemistry...so technically speaking, 99% of health-care problems can be managed by the doctors staying at a remote place—linked by telemedicine.”

 Steve McCrosky sees a patient

Steve McCrosky was 16 when the Centers for Disease Control and Prevention issued its first report of men dying from diseases that very few people had ever heard of. He graduated from high school in 1983, when the collection of illnesses had been named human immunodeficiency virus, or HIV – the cause of acquired immune deficiency syndrome, also known as AIDS.

McCrosky was captivated by the medical and social implications of the growing epidemic. After high school, he enrolled at Northeastern University in Boston, where he received his nursing degree. In 1994, he headed west to San Francisco where he witnessed the AIDS epidemic up close. He realized then that he wanted to be on the front lines of this unprecedented pandemic. In 2001, at the University of California, San Francisco, he completed training to be a family nurse practitioner. 

Teleradiology

Teleradiology is probably the most advanced part of telemedicine in the United States. For nearly a decade almost all radiologic exams have been digital. The film era of radiology passed into history around the turn of the century.

Since radiologists interpret digital images on a computer workstation using picture archiving and communications software (PACS), the radiologist’s location does not really matter as long as the digital images can be easily transmitted to his or her workstation and the formal radiologic report can be transmitted to the patient’s physicians or other healthcare providers. This transmission of images and reports is usually internal to a hospital or medical center, but it can be across town or across the country.

Baby in neonatal unit

Neonatologist Greg Warda, MD, arrived at Yuma Regional Medical Center 15 years ago, the hospital's only full-time neonatologist, and medical director of its neonatal intensive-care unit.

Back then, Warda's most urgent challenge was determining when a sick baby could remain in the Yuma hospital or needed to be transported to a larger hospital where multiple specialists could oversee the baby's care.

ATP Telemedicine training

Although requirements vary for each health profession, in order to maintain licensure, most require some sort of continuing education (CE) to demonstrate competency and insure quality of care. 

Health professionals typically need to take time away from work and personal obligations to obtain continuing education credits, which means meeting these requirements can be fraught with challenging barriers. This is especially true for those practicing medicine in rural communities where opportunities can be very limited. Finding the time to attend educational events is problematic and is compounded by adding more time and expense for traveling to such events, particularly in a rural setting where backup support can be inadequate. 

Since the University of Arizona Medical Center (UAMC) is a teaching hospital, the Arizona Telemedicine Program is in an exceptionally unique position to support health professionals at telemedicine member sites achieve their objectives. The program provides a wide variety of educational opportunities via the content provided to students pursuing a career in health care. 

Telestroke - stroke care with technology

In 2005, patients who were hospitalized with an ischemic stroke in Tucson or Phoenix were 10 times as likely to receive potentially life-saving medical care as patients treated at hospitals in rural Arizona.

Today, patients in rural Arizona have as good or even better chance of receiving the best possible treatment – a “clot-busting” drug called tPA - compared with stroke patients in the state’s two largest cities.

The change came about because of the Telestroke Program at the Mayo Clinic – Phoenix.

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