HealtH Matters 45
telemedicine
Stroke pAtientS to be ASSeSSed
remotely tHAnkS to robo-doc
the Dublin Midlands stroke Network Partnership plan to use the lastest technology to enhance the
service provision to acute stroke patients.
I
n Ireland, stroke (cerebrovascular disease)
accounts for 7.2 per cent of all deaths. In
2007 there were over 7,000 discharges
from hospitals recorded for people with a
principal diagnosis of stroke. the core aim of
care of the stroke patient is to first minimise
the extent of brain damage in the acute
phase of stroke, secondly restore physical,
mental, communication and cognitive
function in the acute through to recovery
phases, and thirdly prevent the occurrence of
a further stroke event.
In about 80 per cent of these cases the
stroke is caused by a blood clot blocking the
flow of blood to the brain. Prompt action can
prevent further damage and help someone
+ Robo-Doc pictured with a nurse at Tallaght
robodoc will be located in the accident and
to make a full recovery. In this instance Hospital, Dublin. emergency department and can be used for
the presence of a consultant to assist in other speciality diagnosis and treatment.
the diagnosis and treatment is essential microphone and television screen, observe "treating stroke patients is time-sensitive,
however specialist consultants are not and help conduct the assessment, view Ct as studies have shown that some patients
always available immediately. Clot-busting images and lab results and make urgent have a better chance of making a reasonable
drugs (thrombolysis), if given on time, have treatment decisions with no delays. the recovery if a clot-busting drug is administered
been shown to be one of the most effective doctor controls the unit through a joystick to within a four-and-a-half hour window,"
therapies for this type of stroke. However, change its vantage point, and the unit could Dr ronan Collins, geriatrician and stroke
research world-wide has shown that less be used for other medical emergencies. It is specialist at tallaght Hospital, said the project
than one per cent of acute stroke patients envisaged that the robo-doc capabilities will involves the development of common clinical
receive this treatment. Patients who are assist significantly in the overall treatment and protocols:
treated have a 30 per cent greater chance of recovery for patients. • an on-call rota
functional independence. the application of telemedicine to the • an evaluation framework
the aims of the telestroke Project is to diagnosis and management of stroke in
facilitate out of hours acute assessment, the acute phase has been primarily aimed Funding for the pilot project has been
diagnoses and intervention care of patients at giving remote access to consultants provided through the Innovation Funds. a
presenting with acute stroke to three acute with specialist stroke knowledge in order resource pool of specialist stroke consultants
hospital sites at adelaide, Meath and National to facilitate timely thrombolysis. While have come together from an identified
Children’s Hospital in tallaght (aMNCH), telemedicine is not a regular feature in network to share information, knowledge
the Midland regional Hospitals in Mullingar Hospitals throughout Ireland, there has been and time throughout the pilot period in order
(MrHM) and Naas General Hospital (NGH), significant activity in the area in the last ten to minimise disability, mortality and prevent
which has a population of over 730,000. years. In 2005, a total of 40 hospitals were recurrence associated with ischaemic stroke.
the three hospital sites will be the first in using telemedicine for radiology, patology, the project team comprises consultants in
the country to have robo-Doc, or a remote neurosurgery, oncology and paediatrician in the three participating hospital centres, Hse
presence (rP7) robot doctor. the robo-Doc Ireland. the most established telemedicine management, ICt staff and research support
allows the consultant to remotely see and network at that time was the national form the Department of Public Health
talk to the patient, via the video camera, neurosurgical teleradiology network. the (tullamore Office).
health matters is 4.indd 45 27/11/2009 20:43:27
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