Telemedicine technology helps MCMC ER doctors confer long-distance with OHSU specialists at the bedside to benefit stroke patients like Clarence Renno.
When an ambulance delivered Clarence Renno to Mid-Columbia Medical Center’s emergency department on a Friday night last February, the 65-year-old was having trouble speaking and felt weakness on his right side.
He was having a stroke – potentially a serious one. But today Renno is back home in Wishram and almost back to normal again, thanks to quick recognition of his symptoms by Dr. Patrick Grimsley, the physician on duty in the emergency room that night; the swift administration of an anti-clotting drug; and MCMC’s participation in Oregon Health & Science University’s telestroke network.
“They saved my life,” Renno says. “I would at least have been paralyzed.”
Telestroke uses robotics and high-definition video to quickly connect possible stroke patients at smaller hospitals with experienced neurologists and stroke specialists at remote locations via the Internet. It can be a huge help to the emergency room physician.
Pictured above: MCMC's Dr. Patrick Grimsley and OHSU's Dr. Hormozd Bozorgchami partnered long-distance via telestroke technology to achieve a successful outcome for a recent stroke patient.
“It’s always great to have another doctor taking a look to ensure that the patient gets the correct treatment,” says Dr. Grimsley, who did the initial examination of Renno and started the stroke protocols in place at MCMC.
The telestroke technology lets the neurologist – in Renno’s case, Dr. Hormozd Bozorgchami, a neurologist and stroke specialist at OHSU – see the patient and talk directly in order to help make treatment decisions more quickly at a time when delay can make a critical situation for the patient into something much worse.
“The best part about telestroke is that it gives me the opportunity to triage a patient actively,” says Dr. Bozorgchami. Not only can the doctor see the patient on video, the patient and family can see and talk to the doctor.
“For a lot of families that is important. It keeps them in the loop. They can hear me talking to the patient instead of my just being on the phone talking to the emergency room doctor.”
The visual contact is vital, Dr. Bozorgchami says, because it allows him to get firsthand information from the patient that will help treatment. In Renno’s case, that meant being able to quickly determine the type of stroke he had sustained administering the anti-clotting, brain-saving drug tissue plasminogen activator (TPA).
The drug must be given within four hours of the onset of symptoms in order to be effective. Statewide, member hospitals of OHSU’s telemedicine network have been able to administer the drug in 30 percent of stroke cases, compared with a national average of 2 to 3 percent.
It also meant that Dr. Bozorgchami was able to determine whether Renno should be transferred to OHSU for further treatment. Renno was moved, but the use of telemedicine has made it possible for 55 percent of MCMC patients who arrive with stroke symptoms to receive care locally, according to OHSU data. That means fewer unnecessary and expensive patient transfers and less time and expense for families who don’t need to travel to Portland to be with loved ones.
For Clarence Renno, telestroke made all the difference. After just a three-day stay at OHSU, the retired railroad conductor was released and able to enter MCMC’s therapy program at Water’s Edge to rebuild the strength in his right side.
He considers the rehab work a small price to pay for getting his life back.
“This was just a miracle,” he says.