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Healthier Together

Spring/Summer 2017 issue
Faster diagnosis and treatment for stroke patients

Faster diagnosis and treatment for stroke patients


When you’re having a stroke — which can cause lasting damage by limiting blood flow to the brain — time equals brain.

That’s a saying among healthcare providers that means the faster you get treatment, the more of your brain’s function can be saved. Fast action means fewer brain cells die from oxygen deprivation.

So the last thing you want is to have to wait for treatment while the neurologist on call rushes to the hospital or while an ambulance takes you to a hospital that provides the specialty care you need.

New “telestroke” and neuroscience services at Novant Health UVA Health System put stroke specialists in front of patients whenever they need them, which is key to reducing the long-term effects of these potentially debilitating medical emergencies.

“This allows you to get the appropriate level of treatment at the right time,” said Duane Campbell, MD, neurosciences medical director of Novant Health UVA Health System Haymarket Medical Center and Novant Health UVA Health System Prince William Medical Center. “Access-to-care barriers are broken. The sooner patients can get the right treatment, the better the outcomes.”

Using a secure telemedicine link, neuroscience specialists such as Dr. Campbell are on call around the clock at Haymarket Medical Center and Prince William Medical Center. They can examine test results remotely but instantaneously and talk to patients via video technology. It does not matter which hospital they’re in.

That’s important because stroke diagnosis can be tricky, Dr. Campbell said. For instance, a patient experiencing sudden left-sided weakness could be having an ischemic stroke or a brain hemorrhage. And those conditions call for opposite treatments.

With the brain hemorrhage, providers want to aggressively control blood pressure to stop the bleeding. With the ischemic stroke, which involves a blocked blood vessel, the provider administers a drug called tPA (tissue plasminogen activator) to thin the blood or will insert a catheter to open up the vessel.

Telestroke services allow providers to make faster, more accurate diagnoses and treatment decisions, getting patients the care they need quickly. In Culpeper, experts from UVA Health System are consulted for stroke patients being cared for at Novant Health UVA Health System Culpeper Medical Center.

Numerous studies have shown the success of telestroke. In a study reported in the peerreviewed journal JAMA Neurology, patients in the Cleveland area who had telemedicine access to a neuroscience specialist received CT scans and tPA much sooner.

Expanding telestroke and neurology at Haymarket Medical Center and Prince William Medical Center provides a continuity of care previously not available for stroke patients.

“We have neuroscience expertise right here, within the system, so patients don’t have to travel out of their own community to make sure they’re getting the best services,” said Melissa Robson, CEO of Novant Health UVA Health System.

That means the neuroscience specialist will see the same medical record as a patient’s other providers and can better facilitate consultations and transfers to various levels of care.

“With this system, you’re working with Novant Health UVA Health System providers who know you and who have full access to your records and your team of caregivers,” Dr. Campbell said. “There’s nothing like having that relationship with your provider. Patients and their families really appreciate it.”

In addition to serving as the first neurology medical director for Haymarket and Prince William, Dr. Campbell also is the hospitals’ first neuro-hospitalist, which means he works out of the hospital and not through a physician group. It’s an emerging neurology subspecialty that focuses on inpatient diagnosis and treatment coordination of stroke and similar conditions.

Novant Health UVA Health System is focused on building excellence in neurosciences. The goal is to ensure that patients at every medical center in the network who have a neurological issue receive the appropriate diagnosis and care within 30 minutes — again, key to improving recovery.

“One of the things I’m really excited about with telehealth and teleneurology is that we can beam in to examine a patient instantaneously, make a diagnosis and make appropriate treatment decisions to provide the best care possible,” said Dr. Campbell.

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