StrokeCareNow Network Helped Twice as Many Stroke Patients Receive Care Throughout Region in 2011

Fort Wayne and the communities throughout northeastern Indiana, northwestern Ohio and south-central Michigan have significantly benefitted from a collaborative group of 22 hospitals known as the StrokeCareNow Network. The SCNN formed three years ago uniting  neurology physicians of Fort Wayne Neurological Center, Lutheran Health Network and Parkview Health, to provide advanced stroke care to rural parts of the region just as it does in Fort Wayne. The past year has produced considerable growth in both the calls initiating the SCNN and the number of patients who have actually received advanced stroke care.

In 2011, one of every four stroke patients evaluated through the telemedicine network needed and received clot-busting therapy known as tPA treatment. The 24 percent dosing rate for patients receiving tPA is substantial considering many people wait too long before going to their nearest emergency room. Steve Smith, administrator, Fort Wayne Neurological Center, gives credit to better awareness in the communities and refining the SCNN process.

“We are delighted to see the fruits of this collaboration between Lutheran Health Network, Parkview Health and Fort Wayne Neurological Center for the common good of the patient,” said Steve Smith, administrator, Fort Wayne Neurological Center. “The success of the StrokeCareNow Network was contingent on engaging the community hospitals in our regional market, having them embrace this collaboration and applying it for the benefit of their residents.”

The timing of treatment for stroke victims is crucial; the sooner they receive treatment the more likely the patient is to have a favorable outcome. Participating hospitals now use the SCNN neurologist to assist local emergency physicians in determining whether or not the patient is appropriate for the clot-busting medication or other treatments.

“Patients suffering from stroke have three hours and in some selected cases up to 4.5 hours from symptom onset to have intravenous clot-buster medication administered that can prevent drastic neurological impairments,” said Rakesh Khatri, MD, medical director, StrokeCareNow Network, Fort Wayne Neurological Center. “Some patients have walked out without any disability when they were treated early enough. In a significant number of cases, we can omit the transfer of patients from their nearest community facility and start intravenous clot-buster medication immediately. That makes all the difference in the outcome for stroke patients.”

Several factors contribute to a nearly doubled figure of 230 telestroke consultations in 2011 up from 116 telestroke consultations in 2010 to the SCNN.

“Our nurses and physicians have really done a great job activating the process and recognizing its value here,” said Tammy Cornelious, administrative director of emergency department, ambulance service and admissions intake, Marion General Hospital. “The great outcomes really make it more rewarding for everyone.

Current StrokeCareNow Network affiliated hospitals include: 
Bluffton Regional Medical Center, Bluffton, Ind.; Community Hospitals and Wellness Centers—Bryan Hospital, Bryan, Ohio, Montpelier Hospital, Montpelier, Ohio, Archbold Medical Center, Archbold, Ohio; Community Memorial Hospital, Hicksville, Ohio; Dukes Memorial Hospital, Peru, Ind.; Dupont Hospital, Fort Wayne, Ind.; Kosciusko Community Hospital, Warsaw, Ind.; Lutheran Hospital*, Fort Wayne, Ind.; Marion General Hospital, Marion, Ind.; Mercer Health, Coldwater, Ohio; Parkview Hospital*, Fort Wayne, Ind.; Parkview Huntington, Huntington, Ind.; Parkview LaGrange, LaGrange, Ind.; Parkview Noble; Parkview North; Parkview Whitley; Paulding County Hospital, Paulding, Ohio; Pulaski Memorial Hospital, Winamac, Ind.; St. Joseph Hospital, Fort Wayne, Ind.; Van Wert County Hospital, Van Wert, Ohio; Wabash County Hospital, Wabash, Ind.; Woodlawn Hospital, Rochester, Ind.

“It is uncommon to have such an extensive network involving 22 hospitals without an affiliation to an academic hospital or university. It is possible since there is 24/7 coverage by neurologists who are intimately involved with the network,” said Dr. Khatri.

Dr. Khatri specializes in interventional and vascular neurology and he has been the medical director of the SCNN since July 2011.

StrokeCareNow Network highlights:

• A comprehensive transportation team of local EMS, mobile ICUs and three helicopters to retrieve the patient and transport him/her to Fort Wayne for quick interventional care. Patients will be able to specify either Lutheran or Parkview as the hospital of their choice to be transported, based on physician availability.

• An ongoing communications program that raises awareness of the signs and symptoms of stroke with the public and emphasizing the sense of urgency for patients to immediately access their local hospital for diagnosis and treatment.

• A toll free number for all regional hospital physicians to reach a neurologist on duty daily to quickly assess the condition of a potential stroke patient.
• Telemedicine link between a neurologist in Fort Wayne and the local emergency rooms at 22 hospitals in the region enabling the patient to be visually evaluated by specialists to determine whether the patient is a candidate for advanced stroke interventional services.

• A multi-directional radiology imaging suite known as biplane angiography, at Lutheran and Parkview hospitals will be used by the physician to guide the treatment program enabling clot-busting medicine to be infused directly in the brain at the site of the stroke, use mechanical devices for removal of the clot, or deploy a stent to assure return of blood flow to the site.

• Participation in patient care by specialty physicians including both neurologists and neurovascular interventionalists on a real-time basis even while the patient is still in a regional hospital emergency room. 

Stroke symptoms include:

• Sudden numbness or weakness in face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eye
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

Doctors say a bystander can recognize a stroke and act fast to get help:

FACE: Ask the person to smile. Does one side of the face droop?
ARM: Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Ask the person to repeat a simple phrase. Does the speed sound slurred or strange?
TIME: If you observe any of these signs, it's time to call 9-1-1.

For more information about the SCNN, visit www.strokecarenow.com.

*Lutheran and Parkview hospitals are considered the main hub for receiving stroke patients from the other 20 facilities.