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News Release

UPMC NORTHWEST STEPPING UP THE FIGHT AGAINST STROKE
Technology obtained with UPMC Northwest Foundation grant advances care

STROKE TECHNOLOGY – UPMC Northwest’s new telemedicine system (demonstrated here by stroke specialist James McLaughlin, DO, of the UPMC Northwest medical staff and Lori Massaro of UPMC Stroke Institute) brings stroke expertise directly into patients’ rooms when Dr. McLaughlin isn’t available.

It was a little after midnight in UPMC Northwest’s Critical Care Unit (CCU) when a change in consciousness and impaired speech suggested the 57-year-old male patient was having a stroke (brain attack). CCU staff members activated UPMC Northwest’s Code Stroke, bringing stroke team members rapidly to the patient’s bedside and prompting a series of protocols including blood tests and a brain CT.

Board-certified stroke specialist James McLaughlin, DO, wasn’t in the hospital, but UPMC Northwest’s new Polycom videoconferencing system made possible the next best thing: a direct audio/video link with a stroke expert at the UPMC Stroke Institute, one of the premier stroke treatment and research programs in the nation. By the time the patient returned from the CT room, CCU staff members had used the new telemedicine technology to establish a connection with the Stroke Institute, and stroke specialist Max Hammer, MD, was live on screen to help direct the patient’s care.

Hospitalist Kathleen Filiaggi, MD, quickly familiarized Dr. Hammer with the case, and he then spoke directly with Dr. Filiaggi and the patient, asking the doctor’s assistance in testing the patient’s speech, coordination, and other neurologic functions.
This examination, the patient’s CT images (UPMC Northwest’s state-of-the-art Stentor iSite digital imaging system gave Dr. Hammer instantaneous access to the CT images taken here), and waning symptoms convinced Dr. Hammer the patient wasn’t having a stroke, and that staff members here could provide care without intensive interventions like the blood clot-dissolving drug t-PA or transport to the Stroke Institute at UPMC Presbyterian in Pittsburgh.

The rest of the patient’s stay was uneventful and he went home the next day, but the case vividly illustrates the new technology’s capabilities and what a difference it can make. “It’s an excellent tool to have,” Dr. Filiaggi says. “It was very helpful when we needed it.”

Because Dr. McLaughlin practices alone, “it’s impossible from a practical standpoint to be here all the time,” he says. “When I’m not around, this improves the level of stroke care as well as the timeliness.”

Acquisition of the Polycom technology was made possible through a grant from UPMC Northwest Foundation, which supports the hospital in its mission to provide high-quality health care for area residents. “Telemedicine represents an important next step in the advancement of our stroke program, and it is very rewarding for the foundation to help bring this technology to UPMC Northwest,” says foundation executive director Roger McCauley. “We’re proud to assist the stroke program and to help complement the efforts of Dr. McLaughlin and our stroke team.”
President Neil Todhunter says the link between UPMC Northwest and the UPMC Stroke Institute greatly emphasizes one of the benefits of being part of UPMC: the opportunity to bring the services of one of America’s best hospitals – as ranked again this year by U.S. News & World Report – to residents of rural
northwestern Pennsylvania.

UPMC Northwest’s comprehensive Stroke Program is the only one of its kind among rural hospitals in western Pennsylvania, and the new telemedicine technology – which also is available in UPMC Northwest’s Emergency Department – is further distinguishing the program.

By bringing a stroke specialist virtually into the patient’s room in CCU or the Emergency Department, “we’re providing another level of care for our patients that hasn’t been available until now,” Dr. McLaughlin says. “The only thing the doctor at the Stroke Institute can’t do is touch the patient. It’s just like me standing in the room and telling our staff what to do.”

One benefit of the around-the-clock access to stroke experts is increased use of t-PA. Despite the I.V. drug’s ability to potentially stop a brain attack in minutes, nationally only about three percent of stroke patients get t-PA, many because they fail to get to a hospital in the early stages of a stroke (within three hours after symptoms begin) when the drug is most effective. But use of t-PA multiplies when stroke experts are available 24 hours a day, including through a video link.

With the new videoconferencing technology, the doctor can say ‘this patient is OK for t-PA, go ahead and use it,’ Dr. McLaughlin says. With this kind of expert medical opinion, “there’s no reason for a hospitalist, an emergency physician, or other non-stroke specialist not to be comfortable giving t-PA,” he says.

UPMC Passavant, for example, treated only three patients with t-PA in 2005, but the number increased to 13 in 2006 after a new telemedicine system linked the hospital with UPMC Stroke Institute, according to Stroke Institute nurse practitioner Lori Massaro, CRNP.

 “Not only is this working nationally, it’s demonstrated to work within the UPMC system,” Dr. McLaughlin says.

UPMC Northwest is considering seeking Joint Commission certification as a primary stroke center – a mark of excellence that would further distinguish the hospital’s stroke program – and the new technology will help meet the criteria for certification, says neurologic nurse specialist Pauline Rankin, CRNP-BC.

The Polycom system is the second major acquisition that UPMC Northwest has made with UPMC Northwest Foundation funds in recent months. Last December the Family Birthing Center used a foundation grant to obtain a state-of-the-art General Electric LOGIQ 3 ultrasound system that helps staff members meet the needs of expectant mothers and their babies.