MSU and Sparrow Health System Partner for Telestroke Network

People in mid-Michigan who suffer a stroke might be miles away from lifesaving treatment. Reaching immediate medical attention is important, but often local facilities don't have a neurologist available, or the advanced diagnostics to assess the nature of the stroke emergency.

Dr. Anmar Razak leads mid-Michigan's Telestroke Network, an initiative designed to connect four rural area hospitals to the Sparrow Neuroscience Facility for more rapid patient treatment. The first phase of the initiative began in April 2013, and includes Clinton Memorial Hospital in St. Johns, Eaton Rapids Medical Center, Hayes Green Beach Memorial Hospital in Charlotte, and Sparrow Ionia Hospital in Ionia.

Sparrow Health System, Michigan State University's Department of Neurology and Ophthalmology, and the MSU HealthTeam have a longstanding collaboration that contributed to the Sparrow Stroke Center earning an elite certification in early 2013. It was the first Michigan facility named as a Comprehensive Stroke Center by the Joint Commission on Accreditation of Healthcare Organizations, an independent nonprofit that certifies U.S. healthcare facilities.

Among the standards for the certification is the continuous availability of trained professionals and medical experts for education, treatment, and patient care addressing a wide range of situations and complexities. Another standard focuses on how quickly critical care is administered after someone experiences a stroke.

Remote-Controlled Audiovisual Camera Equipment

Razak's work connects physicians and staff at each of the four rural hospitals with MSU neurology and stroke specialists at the Sparrow Neuroscience Facility.

"Time matters a great deal with stroke conditions, and the sooner we can evaluate patients, the sooner we can set a course of action," said Razak.

Specialized telemedicine machines that perform as remote-controlled audiovisual cameras are installed at the rural hospitals. When a patient experiencing symptoms arrives at the local hospital, physicians can access Sparrow stroke specialists around the clock by logging in to the network with portable wireless electronic devices.

According to Razak, the Telestroke Network model is designed to be utilized as soon as the patient enters the emergency room. The technology allows the most skilled and knowledgeable stroke specialists and medical personnel to work collaboratively as they set out a course of action.

"We can assist with neurological assessments that can determine whether the patient is experiencing a stroke, and from there, what type of treatment may be necessary. The network allows a more rapid care delivery, and that is critical when time affects long-term outcomes and the chance for a full recovery," said Razak.

Treating a Stroke Victim

MSU senior Trevor Thompson knows how important it is to treat a stroke quickly. On the morning of February 21, 2013 he suffered a clot in his basilar artery system, although he didn't know it at the time. Thinking he would go back to bed and sleep off his symptoms, Thompson didn't comprehend the gravity of the situation. Quick thinking by his roommate, who Googled Trevor's actions and determined it might be a stroke, landed Thompson at Sparrow Hospital where he was assessed and treated by a team of quick-performing specialists.

"They administered the clot-busting drug, and when that didn't work they talked to my family about surgery and the possible ‘deficits' that can occur. It wasn't the best situation to be in," said Thompson.

Then 22 years old, Thompson was one of the youngest patients ever treated by MSU and Sparrow personnel for that particular stroke condition. He estimates that it was no more than an hour between his roommate's observations and the arrival at Sparrow's Emergency Department. Doctors successfully removed the clot from the base of his skull with an embolectomy (a mechanical extraction), and then performed a second surgery days later for a PFO closure procedure near the heart. Thompson made a full recovery, and continues to work with the medical team from the Sparrow Stroke Center for check-ups and post-treatment analysis.

"I was in East Lansing when my roommate drove me to the hospital that day, but my home town is Owosso, which is about a forty minute drive in good weather. I'm so thankful Dr. Razak, and his colleagues at MSU have created the Telestroke Network, because it has the potential to save someone just like me. What I learned was that you have to get to the nearest hospital as soon as possible. They aren't kidding when they say minutes count. If the doctors at the four mid-Michigan hospitals have the ability to dialogue with the stroke specialists at Sparrow, then I'm confident the patients will have the best care possible," said Thompson.

An Expanding Collaboration

Anmar Razak, M.D.

The partnership continues to grow, and Razak is exploring ways to expand the number of hospitals that can connect with the Telestroke Network. His outreach efforts extend to additional health systems, as well as to Wayne State University. He foresees an international capability down the road, particularly if a separate effort with the MSU College of Communication Arts and Sciences can replace expensive telemedicine machines with more cost-effective tablets and smartphones. Another project involves the MSU Department of Computer Science and Engineering working to develop unique, stroke-specific telemedicine software that can be utilized to create a tablet-based network.

MSU faculty and Sparrow personnel also partner to provide education, marketing, and public awareness campaigns to increase awareness of the Telestroke Network and the advanced treatment available for stroke patients in mid-Michigan.

Razak sees great promise in expanding the network and extending the model to other systems, such as an ambulance-based telestroke system that would connect EMTs with stroke specialists as a patient is being transported.

"We have worked together to design a network that offers stroke patients the quickest and most knowledgeable care delivery available. It really is all about time, and how we utilize the time we have," said Razak.