Stroke patients to be treated from afar

Stroke patients in Alaska could soon be treated by doctors thousands of miles away using an Augusta-based telemedicine system.

The REACH Call interactive Web-based system will be installed in five facilities in the Providence Health & Services Alaska system, said REACH Call CEO Sandeep Agate.

The system will be based at the "hub" hospital at Providence Alaska Medical Center in Anchorage, and by mid-April it will fan out to three "spoke" hospitals, which will likely include Bartlett Regional Hospital in Juneau, Mr. Agate said. Eventually there will be seven spoke hospitals across the state, he said.

The interactive system, developed at Medical College of Georgia, includes video and the ability to see crucial test results such as CT scans and allows a neurologist to evaluate a potential stroke patient at a remote hospital where there might be no neurologist on call or no neurologist at all.

The consultation is critical for giving the clot-busting drug tPA in particular to rule out bleeding in the brain.

"A neurologist sitting at home in Anchorage, affiliated with the Providence Alaska Medical Center, which is the hub hospital, could be treating a stroke patient almost 2,000 miles away in Bartlett Regional Hospital in Juneau," Mr. Agate said. "They could see whether transfer is actually needed, or whether tPA has to be given, and possibly save the life of that person."

Without it, the only option in Alaska could be putting that patient on a plane, he said.

"It costs a tremendous amount of money to fly somebody on a fixed-wing aircraft from Alaska to Seattle," Mr. Agate said. "And you could potentially be wasting that money. It could be a mini-stroke or a false positive; it could not be a stroke at all."

With the Alaska addition, REACH Call is now used at 74 facilities in seven states, and the company is in serious talks to add health systems in Texas, Louisiana, Illinois and Ohio, Mr. Agate said.

In Georgia, Medical College of Georgia Hospital serves as a hub for 10 rural spoke hospitals. The system is used at Doctors Hospital and is being implemented in Savannah at St. Joseph's/Candler, with plans for five spoke facilities there. The company is also hoping to persuade the state to back a program that would spread it to hospitals statewide, opening up vast areas where there might be no service for stroke patients.

"So hopefully put every Georgian within 30 miles of a stroke care network," Mr. Agate said.

It is also aiding stroke research at MCG by bringing in rural patients who ordinarily would not be able to access clinical trials. said David Hess, the chairman of the Department of Neurology at MCG and a co-founder of the REACH Call company. It is allowing MCG to rapidly find patients to test the drug minocycline to see if it helps limit damage from strokes.

Future clinical studies could include distant medical centers also, he said. It is a big emphasis by the National Institutes of Health to get clinical studies out into the community, "to try to get out there and get community hospitals and rural patients involved," Dr. Hess said. "We've fortunately been able to do that with the REACH system."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.