Humboldt General Hospital can now provide a higher level of care to patients
experiencing a stroke as part of a new robotic telemedicine partnership with
Northern Nevada Medical Center.
The program gives HGH the resources of NNMC’s Primary Stroke Center
and allows HGH physicians access to neurologists 24 hours a day, 365 days a year.
Due to a national shortage of experienced neurologists, many patients in
smaller communities experience a delay in treatment. That is now changing.
“Our goal is to bring expert stoke care to patients in community
hospitals, allowing patients to remain under the care of their primary
physician and close to home whenever appropriate,” said Alan Olive,
CEO of Northern Nevada Medical Center.
Olive along with other NNMC officials participated in a “TeleStroke
Go-Live Dinner” last month at Humboldt General Hospital that included
local physicians, nursing leadership and other key members of HGH’s
The group was introduced to HGH’s new TeleStroke go-between—a
remote access robot manufactured by InTouch Health that has been installed
in more than 500 clinical locations throughout the world.
Stroke is the fourth-leading cause of death and the top cause of adult
disability in the United States. Telestroke emphasizes speed. Because
“time is brain” and brain is life, there is roughly a three-hour
window from the time stroke symptoms appear until the window closes on
administering tPA (tissue plasminogen activator), the best hope for busting
the clots that otherwise can lead to permanent brain damage.
By the time a patient arrives at Humboldt General Hospital, providers assume
they have an hour to act, said Emergency Services Manager Rita Clement.
With the help of Jeffery Wagner, a Colorado-based neurologist, NNMC ER
Director Shelby Hunt and NNMC Director of Physician Relations and Community
Development Robin Krueger demonstrated how local practitioners can use
that hour to save lives and reduce disability.
Hunt and Krueger explained that when a patient with stroke symptoms arrives
at Humboldt General Hospital, the ED team confirms the stroke symptoms
and then calls Northern Nevada Medical Center, which pages the on-call
TeleStroke physician. At Humboldt General, a nurse rolls the robot to
the foot of the patient’s bed.
The neurologist connects remotely to the robot via software on a workstation,
a personal laptop or even an iPad. The physician can pan, zoom and tilt
the robot’s camera to view the patient’s vital signs and charts,
perform a full examination, and interact and converse with the patient,
family members and medical care providers.
The neurologist then makes a recommendation for treatment, which the ED
team carries out.
Humboldt General Hospital’s new TeleStroke program has been two years
in the making, said Clement. “We didn’t recognize all the
varied aspects of this until we started working toward implementation,” she said.
HGH CEO/Administrator Jim Parrish said the massive effort to bring the
program online has been worth it, however.
“The ability for us to have a neurologist ‘in the room’
to participate in the patient’s examination with our emergency room
staff is invaluable,” said Parrish.
He added, “This program will help us differentiate between low risk
, minor stroke and potentially catastrophic stroke.”
Clement said the new TeleStroke partnership will allow more patients to
stay in Winnemucca, closer to home and their families. Complex stroke
cases will still be transferred to larger medical centers, although the
TeleStroke network will shave precious time off those protocols as well.
The program includes an education component for both hospital staff and
community on the importance of acting fast when there are signs or symptoms
of a stroke.
“We need to involve our entire community in this effort,” said
Clement. “From school children to care giving adults, we need everyone
to recognize signs and symptoms so we can activate our stroke protocols
as quickly as possible. That is where we are going to prevent death and
For more information on stroke, its signs and symptoms, please visit our
Telestroke Network page.