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Jennifer Sheils



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    OS26 - Telehealth in Action (ID 42)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 5/28/2019, 02:30 PM - 03:30 PM, Pod 5
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      OS26.02 - A Comprehensive Telestroke Solution for New Brunswick (ID 521)

      Jennifer Sheils, Telehealth, Horizon Health Network; Saint John/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      The goal of the provincial Telestroke program is to provide a solution that allows every New Brunswick (NB) citizen experiencing an acute stroke the potential to receive leading edge stroke care for this emergency event as well as thrombolysis therapy; specifically a medication known as TPA. The real issues arise with correctly identifying candidates who would benefit from TPA, as well as having a system that is equipped to respond in the rapid manner required and with the additional opportunity to provide this treatment at remote or rural locations and centers that do not ready access to stroke specialists.


      Methodology/Approach:
      Telestroke NB is built upon NB's existing Telehealth capacities, for which we have been previously recognized as a leader in using innovative technologies to provide high-quality intervention, prevention, follow-up, and educational resources to patients throughout our province. Telestroke NB links every 24 hour emergency room, which has computed tomography (CT) access, in the province to an on-demand stroke specialist in real time, regardless of the location of the patient or specialist. Neurologists connect to the hospital network using a virtual private network (VPN) from their home or office to review the CT image within seconds of the scan being completed. This system also allows them capacity to view older CT scans performed on that patient from additional NB sites. They document the necessary clinical assessment performed while connected in real time via interactive audio and video to the emergency room where the patient has presented. In this manner, benefits and risks are communicated to the patient, family and staff at the referring site who also receive advice and support for thrombolysis decisions.


      Finding/Results:
      Telestroke NB is a system that was developed cooperatively between two provincial health authorities (Horizon and Vitalit‚), Ambulance NB, and Heart and Stroke Foundation of NB with the support of the government of NB. This sustainable system was built to align within existing programs and all partners worked collaboratively. It is an innovative, province-wide system for delivering evidence-based acute stroke care and thrombolytic therapy. Each health authority supported the development of consistent guidelines and processes to ensure patients receive care in both official languages as mandated in a bilingual province. Emergency room staffs were integral to the program success as they developed ways to support the remote specialist with performing needed clinical assessments and dialogue with patients and their families.


      Conclusion/Implications/Recommendations:
      Telestroke NB is a sustainable program; improving health by increasing access to quality, evidence-based stroke care in the hyperacute setting. This results in better health outcomes by directly reducing disability caused by stroke. It results in cost-savings by reducing the burden of care for patients who might otherwise require longer hospital stays and long-term nursing care. It also reduces unnecessary transfers and demonstrates the power of cross regional program collaboration. Telestroke NB is one step of a truly comprehensive stroke system; moving towards using Telehealth for primary and secondary stroke prevention. It was launched in collaboration with every facet of the New Brunswick health care system.


      140 Character Summary:
      A province wide innovative technological solution to provision of hyperacute healthcare services.

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