INTEGRATED HEALTHCARE
John Scambler, founder and managing director of MultiSense Communications, discusses the out-of-hours Telestroke service for Lancashire & Cumbria Cardiac and Stroke Network.
T
he Lancashire and Cumbria Telestroke Network is a collaboration between
six acute trusts (across eight hospitals) and seven PCTs in Lancashire and Cum- bria whose aim was to deliver 24/7 stroke thrombolysis for patients with acute is- chaemic stroke living in rural areas.
Lancashire and Cumbria began provid- ing a 24/7 stroke thrombolysis Telestroke service in July 2011. It is an equitable, ev- idence-based service, which provides a re- mote, timely, efficient, quality assessment of the patient by a remote stroke physician consultant at any time of the day or night. The service has demonstrated consider- able cost-savings on long-term care for the stroke patient, and has a positive impact on the workforce due to improved service delivery. It releases time for doctors and nurses in busy A&E departments and it takes pressure off radiology clinical leads and imaging managers.
There is a network of 16 stroke physicians across eight hospitals. Some acute trusts provide three consultants per rota, oth- ers two. An on-call physician rota ensures cover across the whole network, alleviating the pressure for individual trusts to pro- vide cover 24/7. The Telestroke solution is based on Polycom’s HDX high definition videoconferencing technology with mobile carts in A&E and Polycom’s CMAD desktop client videoconferencing software installed on the clinician’s home PC. The solution enables a remote specialist stroke physi- cian to see and speak to the patient and the local clinical team, and also review the CT head scan images, all in high definition. The physician is able to confirm the diag- nosis of stroke, assess the severity, exclude haemorrhage on the CT head scan and ad- vise the local A&E team with the patient, whether thrombolysis treatment would be of benefit. Each consultation is recorded for training and governance purposes.
Since the launch in July 2011, 142 patients have already benefited from a remote video consultation via Telestroke, and 57 patients have received thrombolysis. The potential annual cost saving in Lancashire and Cum- bria is £1.8m annually, which equates to £18m over ten years. In addition, the DH National Stroke Strategy Impact Assess- ment identifies the average ten year cost of dependent stroke as £56,381 per person. The modelling suggests that after the in- troduction of 24/7 thrombolysis, there will
34 | national health executive Jan/Feb 12
be 60 fewer high dependency patients per year. The additional potential cost saving in Lancashire & Cumbria is therefore £2.03m over ten years. The modelling suggests that there will be 24 patients alive who would have died, 36 fewer patients a year who are dependent, and 40 more patients a year with no symptoms or significant disability. The Telestroke service has reduced the need to contact on-call radiologists, thus reduc- ing their workload. A&E departments are benefitting as both doctors and nurses are now using the Telestroke service, speeding up treatment for stroke patients and it saves time waiting for consultants to arrive.
Dr Mark O’Donnell, stroke consultant at Blackpool Teaching Hospitals NHS Foun- dation Trust and clinical lead for the Lan- cashire & Cumbria Cardiac and Stroke Net- work, said: “We are using this new technol-
ogy to take the stroke specialists to the pa- tient, rather than moving the patient long distances around rural areas to where the specialists work. In an acute stroke, time is of the essence and the sooner treatments can be provided the better.”
MultiSense Communications Ltd, Poly- com’s leading Telemedicine solutions pro- vider in the UK and Ireland, designed, im- plemented and supports the entire solution in partnership with the Lancashire and Cumbria Stroke Network. Our specialisa- tion is the development of telemedicine so- lutions for the NHS and includes solutions for; burns, cancer, ophthalmology, derma- tology and more.
FOR MORE INFORMATION
T: 01494 461949 W:
www.multisense.co.uk
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