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StrokeCareNow Network in the News

April 24, 2009

New robot aids stroke network

Parkview creates low-cost technology that can be used in outlying hospitals

By DERRICK GINGERY
derrickg@fwbusiness.com

When a robot that serves as a communications tool between hospitals was deemed too expensive to purchase by the Stroke Care Now network, local health-care workers decided to build one themselves.

The robot is an essential part of Stroke Care Now, a new coalition of hospitals in the area that work together to rapidly treat stroke patients when they arrive in an emergency room. The robot has cameras and is connected to the Internet, serving as the link between a specialist and the patient. It allows a neurologist like Dr. Nils Mueller-Kronast to quickly assess a patient in a hospital outside Fort Wayne and determine whether the person requires advanced treatment.

The robots can cost hundreds of thousands of dollars, and many potential network members either were uninterested in devoting - or unable to devote - the funds for the telemedicine system, Mueller said. So he and Parkview Health's information-technology department developed a new robot that costs about $10,000.

The new robots work so well Parkview decided to phase out its older, and more expensive, army of robots and use those developed in-house. Most Stroke Care Now functions, including robot construction, are being done at cost to keep expenses down for members, Mueller said.

"We had to do it on a budget," he said. "Now it's as good as a commercial system."

Stroke Care Now began operating officially in January. The network electronically links community hospitals throughout the region with Parkview and Lutheran hospitals in Fort Wayne, where specialists are equipped to view stroke patient images and other data, and, if necessary, send a helicopter to the outlying hospital to bring the patient to Fort Wayne for advanced treatment.

The idea is expected to help save lives by treating stroke patients more quickly and giving smaller hospitals in the area access to more advanced care.

Sixteen hospitals in 12 counties have agreed to join the network, including the Parkview Health and Lutheran Health facilities in northeast Indiana. An IT team is assessing the needs at each hospital so the system can be installed and robots deployed. Mueller said a Logansport hospital, which already is paying network dues, is the next to have the system installed.

Video conferencing capabilities were a point of concern when the network was established because the equipment is expensive, especially for smaller hospitals. During one stroke network meeting, Ron Double, Parkview chief information officer, suggested technology was available off the shelf that could meet their needs.

Double and Information Services Specialist Jason Todd spent the next 4 1/2 months developing and testing a home-grown robot. Some parts are custom-made by Parkview staff, while others came from conventional vendors.

The new robots have a touch-screen computer attached to what looks like an IV stand. A monitor and the computer support video-conferencing software. A camera and speakers attached to the robot's "head" allows hospital staff and patients to see and hear the doctor as well as converse.

Unlike the previous robots Parkview had used, the new robots cannot be moved around a hospital from a remote location. They do have wheels, but must be moved into a patient's room by hand.

"The robots that we had that were remote-controlled, someone had to be at the control station or it had to be pushed," Double said. "(This one) is much easier to move around. We were able to reduce costs and improve functionality."

Mueller is able to log in and control the cameras in each robot stationed at a stroke network hospital through a secure Web site. When he needs to assess a patient, he uses a laptop with a built-in video camera to activate the system and talk with staff. Mueller is assessing all of the stroke network patients presently, but once the IT infrastructure is completely installed, 10 neurologists will share on-call sessions, he said.

Parkview also created an internal system to produce more robots as the network grows. To date, demand is low enough that existing staff can build them, Double said.

Steve Smith, CEO and administrator of Fort Wayne Neurological Center, one of the Stroke Care Now partners, said physicians and staff are using what has worked the best at Parkview as the robots and other software are installed in the network hospitals.

"It's a work in progress," Smith said of the network rollout.

In another year, Mueller said the network could include all of the small hospitals in the region. Expansion may come down to pressure from the community as well as state regulators, he said. Presently, there is no required certification program for hospitals treating stroke patients in Indiana, he said.

As for the new robot, it likely will not be sold commercially. Double said Parkview looked at the marketplace and found other models at similar prices.

"We made it too cheap," Mueller said. "It is a way to rapidly expand (the stroke network) in the community. You would lose money."

January 7th, 2009

Stroke network steps closer

Michael Schroeder
The Journal Gazette

Original Web site link

After months in limbo, a regional network aimed at improving stroke care that involves competing hospitals is finally a reality — on paper. It will likely be March before the network begins serving the first participating rural hospital, an official said.

Late last month, Community Health Systems Inc. — which owns Fort Wayne-based Lutheran Health Network — approved the agreement, the final party to do so, Steve Smith said. The chief executive and administrator of Fort Wayne Neurological Center has been a driving force behind the network, StrokeCareNow Network LLC.

Lutheran Hospital and Parkview Hospital on Randallia Drive will serve as the hub hospitals for the network. The hospitals have invested several million dollars to make necessary upgrades. Both have biplane angiography suites where three-dimensional images can be taken of the brain to guide quicker diagnosis and targeted treatment.

Using telemedicine technology — robots providing live video and audio from remote hospitals — specialists based in Fort Wayne will be able to assist with care in rural hospitals and determine whether a patient needs to be transported to Lutheran or Parkview hospitals for additional treatment.

Most of the region's emergency rooms are reluctant to administer clot-busting, or stroke-reversing, medication intravenously, Smith said. If the treatment isn't right for the patient — if it is not administered quickly enough, for example — or if it's improperly managed, the patient could bleed to death.

Neurologists at Fort Wayne Neurological will use video taken by the robots to advise doctors at other hospitals on care. Two specialists, Dr. Nils Mueller-Kronast and Dr. Amit Sanghvi, will provide clot-busting treatments to patients transferred to Fort Wayne.

Lutheran Health Network and Parkview Health both own a 44 percent share of StrokeCareNow and Fort Wayne Neurological owns 12 percent. The organization will be governed by an eight-member board, including representatives from Lutheran, Parkview, Fort Wayne Neurological and two regional hospitals.

Several community hospitals have already committed to joining, but others are undecided. A spokeswoman with Adams Memorial Hospital, which initially balked at joining the network, said it's now leaning toward joining.

DeKalb Memorial Hospital is waiting six months to see how the network performs before it will decide whether to sign on, according to Dr. James Buchanan, the hospital's chief medical officer.

"The network is a positive thing," he said, but the hospital already meets national stroke care standards, and he wants to make sure any change in its approach to care is based on patient outcomes.

Hospitals in the region, including DeKalb Memorial, already send patients to doctors involved in the stroke network.