Giving potential stroke victims access to emergency care earlier and closer to home is the goal of neurological initiatives at Forsyth and Wake Forest University Baptist medical centers.
Both hospitals said yesterday that they will offer 24/7 "teleneurology" services to community hospitals by making neurologists available for diagnosis through videoconferencing equipment that can be brought to the patient.
Response time is critical to the recovery chances of a stroke victim, particularly considering that the clot-busting drug tPA needs to be given within three hours from the onset of the first stroke symptom.
"When a person suffers a stroke, 1.9 million nerve cells in the brain die every minute," said Dr. Cheré Chase, the medical director of stroke and neurocritical care at Forsyth.
"This steady loss of brain cells can often be curtailed through the use of tPA. Determining its appropriate use is best done by trained and experienced stroke and critical-care neurologists."
Forsyth will roll out its service in November at Hugh Chatham Hospital in Elkin and Twin County Regional Hospital in Galax, Va. It also has plans for Brunswick Community Hospital in Supply, which is operated by Forsyth's parent company, Novant Health Inc., and at Kernersville Medical Center when it opens.
Meanwhile, Wake Forest Baptist will provide the service later this year initially to Lexington Memorial Hospital, which it oversees.
The hospitals are taking different approaches to providing the service.
Forsyth's effort will involve both in-house neurologists and access to Specialists On Call, a group that provides a national pool of specialty- trained community and university neurologists. Chase said that 16 Specialists on Call doctors are affiliated with Forsyth Comprehensive Neurology, including being licensed in North Carolina and credentialed at the hospital.
"Our program combines the vast resources of Forsyth's nationally certified, award-winning stroke center with some of the country's leading private practice and academic neuroscience physicians," Chase said.
"For participating community hospitals, having this level of physician expertise on call will help to save lives and brain function for many patients, and may eliminate the need to transport patients to a certified primary-stroke center or comprehensive stroke center for further treatment."
Wake Forest Baptist will rely on five in-house neurologists with its "Tele-stroke" system. The hospital said its stroke neurologists have either completed fellowship training in the care of stroke patients or are board-certified in vascular neurology.
"Using a robotic system allows our stroke experts to virtually interact with a patient in a community hospital miles away as though the patient were right in front of us," said Dr. Charles Tegeler, a Wake Forest Baptist neurologist who serves as the director of its Comprehensive Stroke Center and president of the N.C. Neurological Society.
Baptist officials said they considered the Specialists on Call option, but decided to use local doctors instead.
Stroke strikes about 750,000 people each year in the United States, leaving thousands disabled.
People living in what is called the stroke belt, including North Carolina, South Carolina and Georgia, have higher incidence and mortality rates from stroke than other parts of the country.
rcraver@wsjournal.com
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