Value

Oral Presentation

(V11-03) Telestroke Improves Access to Acute Treatments; Is Acute Management Enough? Facing the Functional Outcomes

Tuesday, April 25
1:25 PM - 1:45 PM
Location: W230 BC

In order to fully capture the impact stroke care has on a patient; measurable functional outcomes are essential and required. Certified stroke centers assess patient progress and stroke severity utilizing a variety of validated tools such as the NIHSS and mRS. Of importance, complication rate and mortality are also examined. Monitoring and reporting of the aforementioned elements as well as discharge disposition accompanied by pre-event baseline status tell a great deal about the level of impact and success of a program on functional patient outcomes. A telestroke network has the same impact on patient outcomes on a grander scale than a single institution. Research has demonstrated the dramatic impact telestroke has had on acute stroke treatment; namely administration of tissue plasminogen activator. Telestroke networks are regional, statewide and cross state boundaries. The hurdle present at this time is the lack of a national database that captures telestroke network patient outcomes and hence a complete value of a program. The lack of a national database limits benchmarking against other systems limiting ammunition necessary to drive process improvement and establish best practice. As a strong telestroke network, we have created a novel internal database dedicated to capturing functional patient outcomes. The database is structured within Research Electronic Data Capture (REDCap). Stroke coordinators from all associated telestroke facilities are prompted monthly to enter telestroke and non-telestroke patient data relative to their acute treatment and discharge outcomes. The database has allowed for concrete evidence of acute treatment with telemedicine and its impact on patient status. This novel database is especially important within our system of care as all associated community hospitals are independent of the hub. In addition, not all network partners utilize the same registries for data management. The REDCap database allows for a central data depository accessible to all. Capturing outcome measures would otherwise be impossible without the secure database created at the hub level. Stronger evidence is necessary via a national registry and cooperation among telehealth networks. Ideally, a telehealth registry would encompass multiple service lines. At the end of this roundtable discussion, you will be able to describe the relevance of a national database in telehealth.

Learning Objectives:

Morgan Boyer

LionNet Nurse Coordinator
Penn State Health Milton S. Hershey Medical Center

Morgan Boyer is the LionNet Nurse Coordinator for the 16 community hospital telestroke network in Central and Northeast Pennsylvania. She holds a variety of degrees and certifications. A critical role in Morgan's position is data management and process improvement. She works closely with assoicated faculty and partner hospital adminstration to drive change.

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Raymond Reichwein

Medical Director of LionNet (Telestroke)
Penn State Health Milton S. Hershey Medical Center

Dr. Raymond Reichwein is a Board Certified Vascular Stroke Neurologist balancing multiple vital roles within Penn State Health; Milton S. Hershey Medical Center. Dr. Reichwein graduated from Pennsylvania State University in 1987 with a Bachelor’s Degree in Premedicine. He continued his medicine studies at Pennsylvania State University College of Medicine in Hershey, Pennsylvania followed by residency at the Milton S. Hershey Medical Center. Fellowship in Neurophysiology concluded in 1997. Currently, Dr. Reichwein is an Associate Professor of Neurology and the Stroke Division Chief. Dr. Reichwein is also the Comprehensive Stroke Center Director and Telestroke Director. He is the Vice-Chief of Medical Staff at the Penn State Hershey Rehabilitation Hospital and Stroke Program Director while also holding the role as Medical Director for the Coumadin Clinic. Dr. Reichwein recently concluded his role as the Capital Regional AHA/ASA Board President while receiving Neurology Faculty Teaching Professor of the Year 6 times during his tenure. Dr. Reichwein’s vested interest in research is evident in participation the RESPECT-ESUS and MaRISS clinical trials.

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Kelly L. Rotondo

Program Manager for LionNet
Penn State Health Milton Hershey Medical Center

Dr. Kelly Rotondo, MSN, DNP, RN is the program manager for LionNet, a 16 community hospital telestroke network in central and northeast Pennsylvania. She has almost twenty years experience in healthcare in a variety of settings, from acute care progressive care unit, hospital administration, and nursing education at all levels. Dr. Rotondo and the LionNet team are passionate about stroke education in all areas from pre-hospital, emergency room, inpatient and follow-up care.

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