• Telemed J E Health · Jan 2004

    Case Reports

    Telemedicine physician providers: augmented acute stroke care delivery in rural Texas: an initial experience.

    • John Y Choi, Anne W Wojner, Robert T Cale, Peter Gergen, Joseph DeGioanni, and James C Grotta.
    • University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. John.Y.Choi@uth.tmc.edu
    • Telemed J E Health. 2004 Jan 1; 10 Suppl 2: S-90-4.

    AbstractWe describe the first report of intravenous thrombolytic therapy for acute ischemic stroke given by a rurally based advanced practice nurse (APN) with a telemedicine team of an emergency physician and stroke specialists. A three-way T1 connection between the APN in Dickerson Memorial Hospital in Jasper, TX, the Houston, TX-based Emtel emergency physician, and the University of Texas-Houston Stroke Team physicians facilitated tissue plasminogen activator treatment 80 min into the patient's ischemic stroke, which was manifested by dysarthria, facial palsy, and near-total left-body hemiplegia (NIH Stroke Scale = 9). She was transferred to Memorial Hermann Hospital in Houston for further care. Within 24 h, her neurologic deficits resolved (NIH Stroke Scale = 0), and she was discharged home within 3 days. This represents successful acute stroke care given by an APN under supervision of a telemedicine physician team and may be an option for underserved areas. Educational training of health care providers remains the key for acute stroke care delivery. This case report illustrates a model for telemedicine that has been cost-effective for rural medical care.

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