Table of Contents
Telemedicine Enables UT Doctors to Remotely Treat Stroke Patients
Two days after Billie “Christene” Ling, left, had
a stroke, she visits with
her daughter, who flew in
from Alaska after learning of her mother’s
situation. Photos by Meredith Raine
The first time stroke patient Billie “Christene” Ling saw her doctor, he was on television.
She was lying in a bed in the emergency room at Dickerson Memorial Hospital in Jasper. More than 100 miles away, neurology professor James Grotta, M.D., was sitting in front of a video camera and television monitor on the seventh floor of The University of Texas Medical School at Houston.
The setup allowed him to see Ling less than 30 minutes after her stroke and guide the medical staff in Jasper through the treatment that would ultimately lead to Ling’s full recovery. Ling could see and hear Grotta, too.
It was the first time doctors at the Medical School used telemedicine and tPA, a clot-busting drug, to treat a stroke patient at a distant site.
The Medical School is one of only a handful of institutions in the United States that is using the technology as a way to evaluate and treat remote stroke patients. It also is the first time nationally that all the treating physicians for this stroke patient were telemedicine providers.
“Research has shown that experience using tPA improves outcome for stroke patients,” said Grotta, who holds the Roy M. and Phyllis Gough Huffington Distinguished Chair in Neurology. “It is more likely to be administered properly, and patients are less likely to develop complications if an experienced clinician is involved.
“In smaller hospitals, such as the one in Jasper, tPA isn’t widely available or isn’t available at all,” he said. “We can extend our knowledge and information through telemedicine and decide whether a patient needs an IV infusion of tPA.”
For Ling, the telemedicine program meant the difference between severe disability and a speedy return to normal activities.
“There is no way she would have gotten this treatment without this technology,” Grotta said.
The medical staff in Jasper has a television and video camera similar to the equipment in Houston. This allows the doctors and patient to see and hear one another.
A telemedicine emergency physician from Emtel Inc., a Houston-based telemedicine company, was online to facilitate the exchange of information, and an Emtel advanced practice nurse administered the tPA in the Dickerson Memorial Hospital emergency department.
“It was fantastic,” Ling, age 72, said two days after her stroke in August. “The camera would zoom in on me, and I could talk to the doctor. I could hear them discussing what they could and could not do.
UT Medical School at Houston physicians John Choi, M.D.,
left, and James Grotta, M.D.,
review the steps that are
required
to get online and treat stroke patients via
telemedicine.
“They decided I needed the tPA, and I could feel it working almost immediately,” she said. “It was really a miracle medicine. Before, my mouth was drooping, and it was hard for anyone to understand what I was saying. I could barely move my arm and my leg. I feel great now. It’s like nothing ever happened.”
The project is part of the Specialized Program of Translational Research in Acute Stroke, which is funded through a grant from the National Institute of Neurological Disorders and Stroke at the National Institutes of Health.
John Choi, M.D., director of the neurorecovery and stroke telemedicine program at the Medical School, said this is an effort to understand how doctors can best use this technology for stroke patients at remote sites. For now, Dickerson Memorial, which is owned by the Greater Gulf Medical Alliance, is the only hospital participating in the program, but Choi said there are plans to offer the telemedicine to stroke patients at other hospitals.
“We want to provide more stroke care to rural areas and demonstrate this can be done through telemedicine,” Choi said.
— by Meredith Raine, Public Affairs