This would require first rapidly identifying the patient when he or she arrives in the emergency department, then doing an exam and determining that the patient did have a stroke, and finally sending the patient for a CT scan to make sure it is not a hemorrhagic stroke, he said.
Even in the best of circumstances, all of this takes a while, Dr. Barsan said.
That process can be made even longer if the required specialists are on call but not on site, because it can mean another 30–40 minutes to get them in, he added.
In the end, if the drug is used within strict guidelines, “I don't think it will matter all that much in terms of harm or benefit to patients,” Dr. Hoffman added.
“But when you put monetary or legal incentives on people to use it, and they use it a lot more because they think they're supposed to, it could be harmful.”
Dr. Broderick noted that the proposed regulation was largely the result of the combined efforts of several medical organizations, including the American Academy of Neurology, the American Stroke Association, and the National Association of EMS Physicians.
“This is a team effort of a lot of organizations who are very passionate about stroke care,” he said.
“To CMS's credit, they really listened well and made an informed and well-articulated decision.”