In the UK strokes are becoming an increasing threat to our health. Every year an estimated 150,000 suffer from one and although seen as a disease only affecting the elderly, children and young people can also be victims.
However, treatment has continued to improve thanks to strong research in the area and specialist consults knowing how to act fast when a patient is diagnosed.
Now technology can have a part to play, as proved by the Cumbria and Lancashire Telestroke Network.
In 2007 a national initiative was launched that said all patients should be able to access thrombolysis treatment – which dissolves clots in the brain causing a stroke – 24 hours a day, seven days a week. Although the intention was sound, not every area of the country had the facilities to make it happen.
“In Cumbria and Lancashire, only one in eight of our hospitals were able to offer the treatment and on a Monday to Friday office hours basis, meaning there were an awful lot of patients who could not access the service,” said Kathy Blacker, director of the cardiac and stroke network in the region.
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“We may have had the specialists but spread over such a large county – 3,500m² – and serving 2.2 million people, we could not deliver on a 24 hour basis.”
The organisation began to look further afield and saw many places internationally were using telemedicine to treat illnesses remotely. This allowed consultants to be anywhere with a strong internet connection and video conference with staff and patients at a hospital, being able to diagnose and order treatment without being in the room.
There are 16 consultants on the rota for the regional strategic health authority of NHS North West able to treat strokes so the organisations decided to team with Virgin Media Business to make the new system possible.
“We now have video as a service running over our 10Gb core network in Cumbria and Lancashire,” said Gus Hartley, the programme lead for ICT infrastructure at NHS North West. “It is a powerful little beast used by a number of public services to put stuff into a private cloud. Having such a strong central resource meant linking up to the telecarts in the wards and the consults at home was very reliable.
“We have installed IP VPN routers with business-class broadband into the consultant’s homes which don’t touch the internet, making it a consistent service.”
On top of the secure network connections, consultants can also access important hospital systems through a custom desktop, enabling them to see images of CT scans, medical records and other appropriate information to help them diagnose a stroke quickly and order the treatment.
We had such support from clinicians and the Stroke Association, everyone wanted it to happen and actually the IT part was the least complicated
Kathy Blacker, director of the cardiac and stroke network
The network is fully managed by Virgin Media Business on a 24/7 basis, which brings great peace of mind to the organisations involved.
“The managed service aspect is so helpful,” said Blacker. “If the system hadn’t worked at night without it there would be no-one to help, but they offer 24/7 to back-up nurses or other staff and troubleshoot any issues remotely.”
The network manager can even go as far as identifying when a telecart is not plugged in and being charged, enabling them to alert the hospital and make sure the equipment is ready for use at any moment.
The system is now up and running and has been used for more than 500 patients; identifying 210 cases where thrombolysis could be used. However, it took a long time to push the scheme through due to numerous bureaucratic processes associated with any healthcare scheme.
“We began exploratory work on this system back in 2008 but it took until July 2011 until it got rolled out,” explained Blacker. “We were lucky that the Department of Health was running a regional innovation fund and we were awarded £250,000 to get the system up and running.
“We had such support from clinicians and the Stroke Association, everyone wanted it to happen and actually the IT part was the least complicated. Once the tender process had finished and the contract signed, it only took seven months to complete the deployment.”
Blacker said there was more to the system than just saving lives as well, with costs for future care being cut significantly for every patient diagnosed and treated quickly.
Building services individually won’t happen but if you build a large strategic platform, there are a lot of possibilities
Gus Hartley, the programme lead for ICT infrastructure at NHS North West
“Not only has this helped save people from dying but also from not suffering long term conditions,” she said. “Obviously this is great for them and their families, but also it is great for the NHS who we have calculated with save £7m in long term care costs.
“The official figure for care costs may be £30,000 per stroke but if that happens to someone young, a lifetime of care will cost much more.”
Looking to the future of the equipment they have deployed, Hartley explained how the NHS was already utilising it for other services and more would come.
“We have added more diagnostic capabilities to the telecarts and the video as a service can now be used for other functions, such as cancer networks or speech and language therapy,” he said. “It is a powerful service.
“We also now have access to the internet and a variety of user interfaces, meaning it could be used on Android devices or iPads, which will also have huge implications for the stroke service.”
Computer Weekly European User Awards
The Telestroke Network was chosen as the winner of the Public Sector Project of the Year in the networking category of the Computer Weekly European User Awards for 2013.
Judges felt the project showed how innovative thinking can reap great benefits on a cost and outcome basis.
The European User Awards also have categories for innovative projects in security, business software, data centres and storage - click here to read all the details of how to enter.
Hartley added: “We have 30 projects right now on telemedicine but the key to these services it to work together with other organisations and do it strategically. Building services individually won’t happen but if you build a large strategic platform, there are a lot of possibilities.”
Blacker agreed the future possibilities of the deployment were an exciting prospect and everyone involved was pleased about the achievements so far.
“All the organisations are really proud of it,” she said. “It was very frustrating for them before when they knew there was a treatment that could be offered but if someone had a stroke on the wrong day, it couldn’t be given.
“Now the network is running, we are exploring our long term goals.”