According to the American Stroke Association, stroke is the fifth leading cause of death in the U.S. In the state of Louisiana specifically, diagnosed strokes are exceptionally high – rising from 1,000 in 2015 to 1,648 in 2017. While the diagnosis rate is rising in Louisiana, the rate of deaths overall in the U.S. is actually lowering – the reduction, the American Stroke Association notes, can be attributed largely to medical treatment advances.
Riverside Medical Center of Louisiana recognized the promise of digital health innovations for improved outcomes, and knew that their patients desperately needed better care and education around strokes. The medical center discovered that many patients were candidates for tissue plasminogen activator (tPA) – an FDA-approved stroke care treatment that can save lives and reduce long-term complications associated with strokes – but still were not receiving this treatment.
Establishing timely access to treatment was also a challenge Riverside Medical Center wrestled with – especially in a rural emergency department (ED) where neurology services were not always readily available. Because of this, providers were spending hours on the phone trying to transfer patients to other neurology specialists.
Riverside Medical Center assembled a multi-disciplinary staff team with diverse expertise in informatics, quality and data management, radiology, pharmaceutical services, finance and analytics. In collaboration with Tulane Medical Center, the Riverside Medical Center team worked to implement a telestroke program within electronic medical records (EMRs) that would grant providers access to neurology services through bedside robotics. To improve access to neurology services, they utilized the database in their EMR to determine the length of stay for stroke patients requiring neurological care, as well as door to needle times. Using the data collected, they were able to track indicators such as door to CT, lab results, neurology evaluations and more.
Throughout the course of the program, Riverside Medical Center also identified a gap in community education regarding stroke-like symptoms, hindering the patient’s and their family members’ ability to recognize stroke symptoms. Through community outreach with focus on population health education and resources, Riverside Medical Center worked to educate community members by providing resources to increase symptom awareness.
As a result, Riverside Medical Center was able to increase timely access to neurology services, leading to reduced patient transfers and door to needle times. Now, providers can consult with neurologists within minutes as opposed to hours – leading to an increase in tPa utilization services and improved patient care and outcomes as a result.
“The advancements in technology here at Riverside Medical Center have allowed our providers to deliver safe, efficient care – and more accurate treatment for stroke patients in our community,” said Thomas Bowden, MD, medical director of the ED at Riverside Medical Center. “As rural providers, participating in the telestroke program gives us more confidence when treating stroke patients because we have neuro expertise virtually at the bedside.”
“Living in a rural community, we have limited resources, but the technology utilized during my time of need made all the difference,” an Riverside Medical Center patient testified. “Having the neurologist on the robot when I arrived in the emergency room saved my life.”
HIMSS is pleased to recognize Riverside Medical Center for their HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 validation. Riverside Medical Center continues to make improvements to their telestroke program and patients continue to benefit from safer, more coordinated care.
In addition to stroke care, Riverside leveraged the EMRAM to reduce medical administration errors. “Riverside Medical Center’s focus on barcode med administration has not only reduced medical errors but made nurses more confident in administration of medications,” said Philip Bradley, regional director, North America, HIMSS Analytics.
“We don’t have a deep bench at Riverside; we don’t even have a bench,” said Peter Sullivan, chief executive officer, Riverside Medical Center. “Our entire team starts and plays. Offense, defense and special teams. That’s what sets us apart.”
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Updated February 21, 2020