In stroke telemedicine (telestroke) at Mayo Clinic Health System, your local provider and the neurologist trained in blood vessel conditions (vascular neurologist) provide care in your home community and may be able to avoid the need for transfer to another medical center.
Stroke telemedicine operates on a hub-and-spoke system. Mayo Clinic serves as the primary medical center (the hub), and Mayo Clinic Health System sites serve as the spokes. In stroke telemedicine, a vascular neurologist at the hub consults with providers people who've had acute strokes at the remote sites (spokes).
In telestroke, many people work together as a team, including a program manager, a clinical coordinator, vascular neurologists, neurosurgeons and radiologists at the hub site, and emergency medicine doctors and other staff at the spoke site. Radiology technicians, informational technology staff, nurses, nurse practitioners and other staff also are important members of the stroke telemedicine team.
Stroke telemedicine consultation
In a stroke telemedicine consultation, an emergency medicine provider at your Mayo Clinic Health System hospital (the spoke) will examine you. If the local provider suspects an acute stroke, he or she will activate the stroke telemedicine hotline at the hub hospital, Mayo Clinic, which has a dedicated hotline and group paging system and vascular neurologists on call 24 hours a day, 365 days a year. The hub's on-call vascular neurologist usually responds within just a few minutes.
After you have a CT scan at the Mayo Clinic Health System hospital (spoke hospital), the vascular neurologist at Mayo Clinic (the hub) performs a live, real-time audiovisual consultation. The vascular neurologist may discuss your medical history and review your test results. The vascular neurologist evaluates you, reviews the CT scan remotely, works with your local provider to determine the most appropriate treatment and sends the treatment recommendation electronically back to the Mayo Clinic Health System spoke hospital.
Having a prompt evaluation increases the possibility that clot-dissolving therapies (thrombolytics) can be delivered in time to reduce stroke-related disability. To be effective, clot-dissolving therapies must be given as soon as possible after onset of symptoms, optimally within 3 hours after you experience symptoms. Sometimes those medications are used up to four and a half hours after symptom onset, or, there may be other advanced therapies that can be recommended by the stroke specialist.