Emergency & Acute Care: Telemedicine
Given British Columbia’s vast geography and the lack of resources in less densely populated areas, telemedicine is a vital tool to help overcome communication barriers to enable expert interpretation of CT scans, among other types of consultation. Telemedicine is a reliable means of diagnosing stroke, and tends to reduce unnecessary patient transfers which then reduces the potential for burdening larger, tertiary care hospitals.
Ontario has made substantial progress in the use of telemedicine for managing stroke, particularly in more northerly regions. Using this system, a referring physician can send a CT image and neurological assessment to the consulting neurologist, who can then provide timely treatment advice, even across great distances. Alberta has similar plans for the use of teleradiology for stroke in their strategy. This is an important element in a strategy that strives to provide a high standard of care across the province.
In B.C., there are many regions that do not have a neurologist, but that do have a CT scanner. Telemedicine offers the opportunity for internists, intensivists, GPs, and ER physicians to consult with neurologists to confirm diagnoses suitable for rt-PA administration.
The BC Telehealth Program (coordinated by PHSA) provides the platform for the stroke strategy to develop protocols in telemedicine and teleradiology. The Provincial Telehealth Steering Committee is currently working to promote the broader use of technology to deliver quality care where parties are separated. The use of telemedicine within the provincial stroke strategy fits this mandate well.
The recommendation to improve the use of telemedicine for acute stroke
in B.C. is:
By collaborating with the PHSA Telehealth Working Group, establish
the use of telehealth/telemedicine to improve diagnosis and support
for acute stroke patients in facilities lacking diagnostic equipment
and/or expertise for evidence-based care.
The following prototype projects are planned or underway in B.C. as part of the BC Stroke Strategy: