State Health Commissioner Novello Announces New Telemedicine Stroke Initiative for Rural New Yorkers

Initiative Will Advance High Quality Health Care for Stroke Patients, Save Lives

ALBANY, NY, September 28, 2006 – New York State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H., today launched an innovative telemedicine initiative that will expand access to stroke care for patients in sparsely populated areas of the state.

"Strokes are a leading cause of death and disability in the United States, with more than 700,000 individuals suffering from recurring, potentially life-threatening debilitating strokes," said Commissioner Novello. "This innovative telemedicine initiative will significantly reshape and redefine the delivery of stroke treatment and care in New York State."

"Rural hospitals have been selected for this initiative in order to address the lack of neurologists/stroke specialists in these communities. Rural communities have a demonstrated need for expert medical stroke diagnosis, but the availability of specialists does not match the need," said Commissioner Novello. "Currently five counties in New York State have no hospitals and 18 counties have only one hospital within their borders. This initiative will ensure that stroke patients in these areas will have access to prompt medical care and improved recovery from stroke."

On average, each year for the past six years nearly 42,000 patients have been treated for strokes at hospitals in New York State.

The initiative will allow neurologists at hub hospitals to provide "real time" consultation and recommend treatment based on assessment of the patient and review of computed tomography (CT) scans over the internet in communication with rural spoke hospitals miles away. This telemedicine initiative will utilize a broadband-connected personal or laptop computer with wireless web-based equipment that includes sophisticated security and privacy protections.

In addition, this new telemedicine initiative will permit emergency medical personnel in rural areas of the state to care for stroke patients in a nearby hospital that will be able to provide specialty services through a consultation with specialists at a hub hospital, utilizing a secure web base. This consultation through telemedicine will significantly increase access for stroke patients to the highest quality health care, and will provide assessment and treatment within the first "golden hours" after a stroke. Thrombolytic tissue type plasminogen activator (tPA), a "clot-buster" drug, is one of the most effective treatments for stroke victims, but it must be used within a three-hour window after a stroke. The ability to provide this timely treatment is expected to significantly reduce rehabilitation time in stroke patients.

Joining today's Albany press conference through a web-based, interactive connection were Millard Fillmore Gates Circle Hospital in Erie County, serving as a "hub," and Olean General Hospital, serving as a "spoke," to demonstrate the high-tech capabilities of telemedicine. Dr. Novello led the simulated demonstration showing the effectiveness of these major medical/trauma centers to assist rural "spoke" hospitals with the rapid assessment and recommendations for treatment of stroke patients. Bassett Hospital in Cooperstown, Otsego County, is also one of the two hub hospitals in the initial phase of the initiative.

"The State Health Department has already worked successfully with hospitals statewide to establish more than 90 on-site, operational stroke centers," Dr. Novello said. "However, we recognize that there is a true need for these services in rural areas of New York. The advancement of this new telemedicine initiative will help significantly increase the number of rural hospitals that will now have the capability to provide specialty stroke care to patients."

Currently, stroke victims must be transported to the nearest designated stroke facility, which could be much farther away than a spoke hospital, a trip that sometimes can entail a lengthy journey crossing county lines and delaying necessary treatment to the detriment of the patient.

In addition to Bassett Hospital and Millard Fillmore Hospital, the other medical trauma centers that will serve as hubs include Albany Medical Center (Albany County), State University of New York (SUNY) Upstate Medical Center in Syracuse (Onondaga County) and Strong Memorial Hospital in Rochester (Monroe County). The additional hubs are expected to begin participation in the program by the end of 2006.

Dr. William Streck, President and Chief Executive of Bassett Healthcare said: "We are proud to be part of this innovative approach to enhancing health care services to the people of our region in New York State."

"There is no question that telemedicine can play an increasingly important role in ensuring that residents of rural areas of our State and nation have access to the latest diagnostics and therapies," said Steven M. Frisch, M.D., Executive Vice President for Integrated Delivery Systems and Hospital Systems General Director at the Albany Medical Center. "Commissioner Novello is to be commended for creating the energy around the development of this important hub-and-spoke network for stroke diagnosis and care and, as a State and JCAHO-designated stroke center, we share her enthusiasm for such critical and potentially life-saving efforts."

"Today, the horizon for acute stroke treatment is unlimited. More and more people, including physicians, patients and emergency medical technicians such as ambulance crews, are aware of the potential to successfully treat acute strokes. Also, the technology to treat acute stroke has improved dramatically, said Dr. L.N. Hopkins, M.D., of Millard Fillmore Gates Circle. "My hat is off to the State Department of Health for making this the first statewide initiative for the treatment of acute stroke in this country."

"Residents of our State's rural communities deserve the benefits that new technology brings to health care," said Gary Fitzgerald, President of the Iroquois Healthcare Alliance. "Governor Pataki and Commissioner Novello should be commended for promoting the use of this 'telestroke' technology in our State's rural hospitals. Using this technology to diagnose and treat strokes is only the beginning. Once this technology is in place, rural hospitals will have a high-tech tool which will assist them in making crucial clinical decisions resulting in improved patient care."

In essence, the program will work like this:

  • A stroke patient is transported to a spoke hospital by ambulance;
  • The emergency department of the spoke contacts the hub hospital, which then contacts its on-call neurologist who uses a laptop computer with wireless service to go into the REACH system;
  • An audio and visual link is then established between the patient and his spoke doctor and the neurologist;
  • After completing a stroke assessment, the hub doctor will then make a treatment recommendation, with the treatment carried out by the spoke doctor.

"On behalf of the State EMS Council, I am delighted that Commissioner Novello is advancing the exploration of telemedicine usage for the care of stroke patients in community hospitals," said Anthony J. Billittier IV, MD, FACEP. "The potential benefits from a virtual presence of various specialists and sub-specialists in any emergency department are exciting and the EMS community looks forward to continuing to be a partner in advancing other applications of this technology."

The Department's Telemedicine Stroke and Trauma Program is modeled after a successful program in Georgia known as the Remote Evaluation of Acute Ischemic Stroke (REACH).

"Commissioner Novello's initiative is the most comprehensive implementation of a telestroke solution in the United States," said Sandeep J. Agate, chief executive officer of REACHMDConsult Inc. "Essentially, stroke care will be available in virtually every corner of New York after REACH is completely implemented in the State. We are pleased that REACH will help to improve stroke care in New York State."

One urban hospital, Niagara Falls Memorial Medical Center, is also participating as a spoke hospital as a way to demonstrate the potential future use of REACH in urban settings.

"This new program clearly distinguishes our ER1 Emergency Department as the only choice for patients exhibiting stroke symptoms in the Great Niagara region," said Joseph Ruffolo, President and CEO of Niagara Falls Memorial Medical Center. "Every minute counts when you're suffering a stroke. The REACH program, and our collaboration with the comprehensive Stroke Care Center at Millard Fillmore Gates Circle Hospital, will save precious minutes and save lives."

Telemedicine is one of the Department of Health's "global" strategies for New York State in electronic health, electronic prescribing and electronic image transmission (x-rays, catscans, MRI's, electronic health records). It is expected to decrease medical errors, increase efficiency and lower costs.

The following hospitals are participating in the first phase of implementation of this new telemedicine stroke care initiative:

Spoke Hospitals County
O'Connor Hospital Delaware
Little Falls Hospital Herkimer
Bassett Hospital of Schoharie County Schoharie
Community Memorial Hospital Madison
Spoke Hospitals County
Cuba Memorial Hospital, Inc. Allegany
Memorial Hospital of William F. & Gertrude F. Jones Allegany
Olean General Hospital Cattaraugus
TLC Health Network - Tri-County Memorial Hospital Cattaraugus
Brooks Memorial Hospital Chautauqua
TLC Health Network - Lake Shore Hospital Chautauqua
Westfield Memorial Hospital Chautauqua
Inter-Community Memorial Hospital at Newfane Inc. Niagara
Medina Memorial Hospital Orleans
Wyoming County Memorial Hospital Wyoming