VST have installed VIMED TELEDOC 5 HD+ telemedicine carts at each of the participating hospitals. Each site participating in the VST service has a VST telemedicine cart located in the Emergency Department which can be utilised for patients presenting with acute stroke symptoms. The VIMED TELEDOC 5 HD+ delivers high definition audio and video technologies for communication between the VST site and the stroke consultant.
In addition to the telemedicine carts, VST also require access to brain imagining. VST sites push PACS images to the VST PACS client which provides VST Consultants with real-time access to CTB, CTA and CTP images. VST receive raw CTP data and utilise automated perfusion software to generate our own perfusion maps.
Equipment
VST have VIMED TELEDOC 5 HD+ telemedicine carts at each of the participating hospitals’ Emergency Departments. VST telemedicine carts are utilised for patients presenting with acute stroke symptoms.
The VIMED TELEDOC 5 HD+ delivers high-definition audio and video technologies for communication between the VST site and the stroke consultant.
Each stroke consultant utilises the VIMED platform, installed on a laptop, to dial into the required telemedicine cart.
24/7 support is offered by our service provider Meytec for all technical aspects of our telemedicine requirements.
Brain imaging
In addition to the telemedicine carts, VST also require access to brain imagining.
Visage (Promedicus) is a thin software which provides our stroke consultants with the ability to access and manipulate brain imaging rapidly. Server-side rendering allows images to be manipulated on the server and streamed to the stroke consultant, instead of large files needing to be downloaded on the stroke consultant’s PC.
StrokeViewer (Nicolab) is an automated imaging analysis software that provides mapping of brain blood flow (CT Perfusion) and detection of blood clots blocking brain arteries.
With these images, stroke consultants can positively identify brain tissue at risk (penumbra) and already infracted tissue to make a treatment decision, or transfer to a Melbourne hospital for further treatment.
This imaging technology is an important biomarker in the diagnosis of ischaemic stroke. It allows stroke consultants, regardless of their location, to view and assess brain images of suspected stroke patients.
Clinician documentation
VST consultations are documented using a customised REDcap report form. Clinical details and timeline metrics are documented, allowing for detailed data analysis and reporting. At completion of the consultation a letter is generated, which is then promptly sent to the referring hospital for inclusion in the patient’s medical record.
The other key element to VST is close integration with the Australian Stroke Clinical Registry (AuSCR). AuSCR, a national stroke outcomes and processes of care database monitors, promotes, and improves the quality of acute stroke care.
The AuSCR is used to collect data from participating hospitals across Australia to reduce variations in care, and ultimately, decrease preventable deaths, disability, or recurrent stroke using an online web tool, the Australian Stroke Data Tool (AuSDaT).
Hospitals can use the online tool to:
- store patient data
- produce reports summarising patient data
- export data for local analyses
- support performance reviews, presentations, and publications
Pre-hospital notification
Whilst under the auspice of the Florey Institute of Neuroscience and Mental Health, VST piloted a pre-hospital notification app – Pulsara™ STOP Stroke/ST Elevation Myocardial Infarction (STEMI) at two sites, Ballarat Health Services and Bendigo Healthcare Group.
Results from the Pulsara pilot study demonstrated significant reductions in treatment times including Door to Balloon (STEMI) and Door to Needle (acute ischaemic stroke).
The Pulsara App allows immediate notification by paramedics to a hospital of an incoming stroke or STEMI patient and allows the hospital to plan accordingly and accelerate the time for treatment.
The App securely communicates patient information and establishes a visible timeline for delivery of all the key elements of patient care.
Find out more about Pulsara and STEMI, and Pulsara and Stroke.