Telemedicine shrinks the West’s vast health desert

Every minute counts during a stroke. Blood-thinning drugs and surgery can prevent traumatic brain injury, but doctors must act fast: A life-saving procedure called a clot retrieval, for instance, is only effective within about eight hours of a stroke’s onset.  A drug called tPA, which dissolves stroke-inducing blood clots, must start acting within about four hours. Moreover, a wrong move can be deadly when treating a stroke patient. Few rural emergency room doctors are trained to confidently make such high-stakes calls. As a result, only a tiny fraction of rural stroke victims eligible for the life-saving blood-thinner actually get it, said Howard Yonas, a neurosurgeon at the University of New Mexico.  Instead, many rural doctors opt to fly patients by helicopter to the state’s only Level 1 trauma center in Albuquerque, a costly and sometimes unnecessary measure that consumes precious hours. Now, Yonas and other New Mexico doctors are turning to the power of remote medicine to help stroke patients avoid expensive life-flights and receive timely procedures. The strategy is to loop Albuquerque specialists into rural emergency rooms by video and immediately share brain scans before deciding to transfer the patient. The program, called Access to Critical Cerebral Support Services, or ACCESS, started in 2014 with a $15.1 million grant from the U.S. Centers for Medicare and Medicaid Services. In the two years since, one hospital in Roswell has gone from shipping about half its brain trauma victims to Albuquerque to transferring just 6 percent.