How OSU's Telestroke Robots Are Improving Rural Stoke Care
"The first time a patient experiences it, it does seem a little odd," says Diana Greene-Chandos, MD, the director of neuroscience critical care at Ohio State University's Wexner Medical Center in Columbus.
"They say things like, 'Do you want me to answer you?' Though once we get going with the consult, it becomes the same as if I was really there."
An innovative telestroke program at OSU is allowing Dr. Greene-Chandos and other Wexner physicians to examine stroke patients in rural parts of Ohio remotely through a two-way camera and video monitor brought into the room. The equipment used varies among the 28 rural sites participating in the program, from a nurse wheeling in the camera and monitor on a cart to a robot that can be driven remotely through the hospital's corridors to a patient's room.
The program launched in May 2011, funded in part by a grant from the state of Ohio to improve stoke care in more remote parts of the state. "We focused on areas that were very rural and where it was difficult to access timely care," says Dr. Greene-Chandos, "where we knew it would be difficult for someone [having a stroke] to get to a tertiary care facility and get treatment within the recommended three hours."
As of May 30, the program has facilitated 837 remote consults with stroke patients, and Dr. Greene-Chandos has seen the improvement in patient care. "We've been able to substantially increase the number of patients who receive [a tissue plasminogen activator] substantially," she says, "and hospitals that haven't been able to administer tPA now can," under the guidance of qualified OSU physicians. Patients do not have to be transferred to Wexner to receive this often lifesaving treatment.
"The technology is just so good I can see and do almost everything remotely," says Dr. Greene-Chandos. "Regardless of the system or robot used, we're able to fill our whole screen with the patient's eyes — we can zoom in that close."
Despite any initial hesitation over conversing with a robo-physician, Dr. Greene-Chandos says the program has been very well-received among patients. "They really appreciate it, getting access to care they otherwise would not have," she says.
Dr. Greene-Chandos says the technology does not stand in the way of connecting with patients like she would in person. "Through the TV screen I can see everything, including the patient's emotions and concerns, and address those, too," she says.
Physicians at partnering hospitals appreciate the program as well. "It offers a real-time consult with no waiting," says Dr. Greene-Chandos. "If you had a neurologist on-call and at his or her home, it might take 10, 30 minutes for them to drive in," she says. "We're there right away."
OSU plans to keep expanding the telestroke program, partnering with any interested rural hospitals in the state. "If there's a need in a certain community, we want to bring them on board," says Dr. Greene-Chandos. She is also looking forward to expanding the program's offerings to a broader spectrum of neurological care, including intercerebral hemorrhages, aneurisms and other conditions that benefit from early intervention.
"I'm not the best computer person, but this program is so seamless and easy," says Dr. Greene-Chandos. "I feel like this is going to be the future. This is how we're going to improve access to care."
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