Humboldt General Hospital Launches Robotic Telestroke Program

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 stroke team.

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 disability.”

For more information on stroke, its signs and symptoms, please visit our Telestroke Network page.

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