MEDICINE: Telemedicine boosted by stroke study
UCSD Med Center, local companies collaborate
By BRADLEY J. FIKES - Staff Writer | ∞
Stroke patients can be diagnosed with dramatically greater effectiveness by a program that connects them to doctors through the Internet, according to a UCSD Medical Center study.
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The program, called Stroke Doc, was developed by the center and two local companies to improve stroke care in remote locations far away from stroke experts.
Stroke Doc improved accuracy from 82 percent by telephone to greater than 98 percent, said Dr. Brett C. Meyer, co-director of the UCSD Medical Center Stroke Center. A study of Stroke Doc was halted when it was just over halfway through, because the results were so clear, Meyer said.
The collaboration gives scientific backing to the emerging field known as telemedicine, which hooks up doctors and patients at a distance through the Internet. it also unites two of the county's leading industries, life sciences and wireless communications, to lower the cost of health care and improve quality.
Carmel Valley-based BF-Technologies makes the program's audio/visual equipment, which the company says delivers an exceptionally stable video signal. The equipment costs about $24,000, the company says.
San Diego's Qualcomm Inc. developed the broadband wireless technology used to transmit information through a laptop when there's no wired connection. Now available to consumers, it was made first available for the Stroke Doc study.
This is the first time telemedicine has been scientifically demonstrated to improve patient care, as compared to a telephone consultation, said Meyer, co-director of the UCSD Medical Center Stroke Center.
"Telemedicine has been used for about 10 years, and there's been an assumption that it's been effective," Meyer said. "But it hasn't been tested."
The study was funded by the National Institutes of Health. It was published Aug. 2 in the online issue of the journal Lancet Neurology.
A standard broadband Internet connection and the BF-Technologies videocamera equipment is all that's needed on the patient's side, Meyer said. Alternatively, a wireless broadband connection through Verizon Wireless or Sprint can establish the connection through Qualcomm's technology.
"We've been stuck in traffic, and an ambulance has been stuck in traffic with us, but we've been able turn on a laptop and access one of the camera systems," in the ambulance, Meyer said.
BF-Technologies' Internet video technology, "delivers a true representation of what the patient is actually doing," said Ronald Fellman, president and chief executive of the privately held company. That helps the doctor examine closely for signs that indicate the patient's condition.
"A neurologist looking at the patient's motions is analyzing to see if there's any jerkiness. The problem is if you were to send video over a (standard) computer network), the video could end up looking glitchy ," Fellman said. "It could make it impossible for the doctor to distinguish whether a jerkiness in the motion is because of the patient or because of the network."
Strokes kill more than 150,000 Americans annually, making it the third leading cause of death, according to the American Heart Association. Those who survive may suffer permanent brain damage. Prompt treatment reduces the risk of death or damage, not only improving patient health but saving money that would otherwise be spent on rehabilitation.
Most strokes are caused by blood clots in the brain. These can be broken up by a clot-busting drug called tPA, ending the stroke, Meyer said. But tPA is dangerous in some instances, Meyer said. If wrongly given the drug can cause brain hemorrhage or death.
That's where Stroke Doc comes in, Meyer said. It gives a distant stroke expert the detailed information needed to decide whether tPA should be given.
Other partners in the study included Calit2, a research program of the UC system, and the Jacobs School of Engineering at UCSD.
Contact staff writer Bradley J. Fikes at (760) 739-6641 or bfikes@nctimes.com.
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terry wrote on Aug 4, 2008 12:59 PM:how about heatstroke? i grew up in the
roasting hot san fernando valley.
born just off skid row on hope st. in
downtown los angeles in 1950. our family never had air conditioining
until 1970. the smog used to be so
thick you could cut it with a knife.
we hardly used the air conditioning,
it was too expensive to run. it was
107 degrees here in san marcos, ca,
yesterday. it was like being roasted
alive. i cooled off in the shower
every half hour. i soaked my shirt
in cold water and wore it to cool off.
its too darn hot. but not as hot
as 29 palms, thank god.
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