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ProMed to participate in pilot stroke telemedicine program

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Union County is at the forefront of a new pilot trial with stroke detection equipment in one of the ProMed ambulances.

The goal of the program is to detect whether a patient is having a stroke while in the ambulance in order to shorten the time between arriving somewhere and getting treatment.

The program is funded by the Arkansas Department of Health, organized by University of Arkansas and led by Arkansas Stroke Assistance through Virtual Emergency Support (AR SAVES) with ProMed Ambulance Service in El Dorado. It is also in partnership with UAMS Center for Distance Health, the Department of Human Services and 55 hospitals including the Medical Center of South Arkansas.

The pilot program will study the effectiveness of telemedicine in an ambulance.

“One year ago we responded to an email, a late night email as a matter of fact, from the Department of Health saying they wanted to know what ambulance services might be interested in piloting a stroke telemedicine ambulance, particularly in rural areas,” said Ken Kelley, CEO of ProMed. “And particularly in areas of the state that have significant levels of stroke mortality.

“Unfortunately, our part of the state has a level of stroke and much of the care that’s delivered wasn’t delivered in a timely manner. That certainly is not a reflection about the quality of the medical services that we have. It was more of a timing and an accessibility issue.”

When it comes to the equipment for the ambulance, the one currently set up includes a touchscreen that allows paramedics to call ahead to a stroke neurologist and three cameras over the patient so that the doctor on call can look for visible signs of a stroke.

The collection of three cameras can be adjusted and zoomed in or out for the doctor to get a better view of telling signs such as the patients facial movements. One camera is directed toward the patient’s face, another is directed toward the patient’s legs and the third is designed to be an overview to look at the patient’s entire body.

Common signs of a stroke include: numbness or weakness particularly on one side of the patient’s body, difficulty speaking, trouble seeing with one or both eyes, problems walking or staying balanced, dizziness and severe headache. With the cameras, a doctor can look for signs of muscle twitches or disorientation.

The goal is to be able to do most of an external examination while a patient is in the ambulance before they get to the hospital so that they can get a CT scan faster after arriving and therefore get treatment faster to avoid more damage.

“Each minute we have a stroke, we lose about 1.9 million neurons,” said Dr. Sanjeeva Reddy Onteddu, AR SAVES medical director and a doctor with UAMS. “What we have been doing with our program is to see what our total response time is in our program. We have been consistently about 72 minutes. Our targets are less than 60 minutes per patient.”

This one ambulance is the result of a year of research, testing equipment in various areas, revising protocol, troubleshooting and performing mock trials. In the end, Kelley said the cost to set up one ambulance with the equipment was between $3,000 and $4,000.

One of the challenges Kelley said ProMed still expects to face is the dead spots of service surrounding Union County. He said they’re keeping an eye on the developing technology as a way to combat the issue, but it is something that will continue to evolve as more options become available.

Another challenge he said is the need for people to actually call 911 when they’re having a stroke. He said many people still try to drive themselves to the hospital when they’re showing signs of a stroke. People need to understand that time equals brain cells, he said, and the sooner a health care professional can look at them, the more brain cells they can save.

“We want all the communities served by ProMed to know that EMS Stroke Telemedicine is available in their town and to call 911 and specify that they or someone they know are having stroke symptoms,” Onteddu said in a release. “That will ensure that the telemedicine ambulance is dispatched.”

Michael Shine may be reached at 870-862-6611 or mshine@eldoradonews.com. Follow him on Twitter and like him on Facebook @MichaelAZShine for updates on Union County school news.

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