Conference Coverage
The Neglected First Year
Dr. Gaines helped create a comprehensive stroke care model at Ochsner Medical Center in New Orleans that incorporated telemedicine. The program targeted acute stroke treatment as well as what Dr. Gaines calls the neglected first year after hospitalization for stroke. “In the chronic phase of stroke, these folks have significant disability. It is a significant stressor for their families and their caregivers, and unfortunately we have relatively poor risk factor control and inadequate medication compliance in this segment,” he said. Patients have high death rates due to recurrent stroke, complications of stroke, and other cardiovascular diseases.
The medical center provided telemedicine consultations to 22 affiliated hospitals. In addition, a Stroke Mobile team that consisted of a nurse and a health educator visited patients’ homes monthly for one year to address stroke risks and complications. Stroke Mobile staff used HIPAA-compliant video communication to facilitate telemedicine consultations with a vascular neurologist or advanced practice clinician during the home visits.
This model decreased length of hospital stay by one day, decreased cost per case by 9%, and lowered readmission and stroke recurrence by about 17% each. Furthermore, between 85% and 90% of patients achieved control of risk factors such as blood pressure, diabetes, and cholesterol. “Projects like this can offer us a much better, more comprehensive approach,” said Dr. Gaines.