Each year, medical staff diagnose approximately 4,500 Veterans with an acute ischemic stroke (AIS). Stroke is the fifth leading cause of death in the United States and the leading cause of serious, long-term disability.
The VA National Telestroke Program (NTSP) serves Veterans with acute stroke symptoms at VA emergency departments, urgent care centers and hospitals.
In the photo above, a Birmingham VA nurse uses mobile technology to consult with an NTSP neurologist.
Telestroke simulation January 29 in the Nashville VA Emergency Department
A growing technology
Dr. Glenn Graham said the program has grown in providing acute stroke expertise to VA facilities that lack around-the-clock acute stroke coverage. Graham is the program’s executive champion and founded the program in 2017.
The NTSP is comprised of a virtual “hub” of VA stroke neurologists located around the country. They participate in a 24/7/365 call schedule to provide coverage to participating facilities. Dr. Sharyl Martini, NTSP medical director, said the program has 22 neurologists covering Telestroke services for 40 VA facilities, with 20 additional facilities forecast to be added annually from fiscal year 2021 through 2023.
When a Veteran with acute stroke symptoms presents at a participating VA facility, front-line staff use a mobile device to videoconference with the Telestroke neurologist. The neurologist examines the patient and reviews the medical record and CT images. They then advise the local treating physician of the diagnosis and recommend treatment. The staff enters the recommendation in the patient’s record. The local treating provider executes the recommendations.
“Before a VA Telestroke facility activates Telestroke services, the NTSP team conducts a 2 ½ day go-live course onsite, including 3 to 4 Telestroke simulations,” said Dr. Jane Anderson, the NTSP director of education.
The team uses standardized patients in simulation scenarios involving a patient presenting with stroke symptoms. SimLEARN RN Faculty supports the program. Each simulation involves mobile technology and simulated waveforms on actual patient monitors to increase simulation fidelity. Staff follow the patient through initial diagnosis, communications with the Telestroke neurologist, CT scan and medication administration.
According to Bill Cerniuk, NTSP chief technology officer, the field of VA Telemedicine continues to expand and is positively impacting care for our Veterans.
VA Mobile Technology and Simulation supporting the Telestroke Program are helping reinforce provider learning and improve patient care. The technology is provided via Virtual Reality, Serious Gaming, Artificial Intelligence and Standardized Patients.
May is Stroke Month. The theme is “I will not have another stroke.”
Get the facts about strokes from VA’s My HealtheVet.
(All photos taken before COVID-19 in 2019/2020)
By David J. Adriansen, Director of Simulation, VA National Telestroke Program