This is a major problem, medical persons not recognizing when a newer process/procedure needs to be implemented. They were way too focused on getting tPA to work and missed possibly better ways to tell the difference between hemorrhage and ischemic. See 11 possibilities here; Damn don't people ever think at all.
http://www.healthcanal.com/public-health-safety/34565-Telestroke-Cost-effective-for-Hospitals-Mayo-Clinic-Researchers-Show.html
In telestroke care, the use of a telestroke robot allows a patient
with stroke to be examined in real time by a neurology specialist
elsewhere who consults via computer with an emergency room physician in the rural site.
"Previous studies have demonstrated that a hub-and-spoke telestroke
network is cost-effective from the societal perspective — we can assess
medical services, like telemedicine, in terms of the net costs to
society for each year of life gained," says neurologist Bart Demaerschalk, M.D., director of Mayo Clinic
Telestroke Program, and co-author of the telestroke cost effectiveness
study. "However, to date the costs and benefits from the perspectives
of network hospitals have not been formally estimated."
Contrary to a common perception that a telestroke referral network poses a substantial financial burden on hospitals, the study revealed that it is likely to save hospitals money and also improve patient outcomes by enabling patients to be discharged sooner.
"The health economic results from an earlier study conducted from
the societal perspective convincingly demonstrated that telestroke was
cost effective compared to the usual model of care," says Dr.
Demaerschalk. "It's a relatively small amount of money, comparatively, telestroke costs a couple thousand dollars more to save quality years of life — so it's a bargain really."
The Circulation study estimates that compared with no network, a
telestroke system of a single hub and seven spoke hospitals may result
in the use of more clot-busting drugs, procedures and other stroke
therapies, more stroke patients discharged home independently, and
despite upfront and maintenance expenses, a greater total cost savings
for the entire network of hospitals.
Using data from Mayo Clinic and the Georgia Health Sciences University telestroke networks, the research model estimated
that every year, compared to no telemedicine network, 45 more patients
would be treated with intravenous thrombolysis and 20 more with
endovascular stroke therapies — leading to 6.11 more independent
patients discharged home. This represents more than $100,000 in cost
savings for each of the participating rural hospitals each year, according to the study.
"If the costs associated with the technology are reduced or if
reimbursement opportunities increase we will recognize that this
treatment method may, in fact, save even more money," Dr. Demaerschalk
says. "The upfront costs associated with setting up the telestroke
technology and managing the network organization are quickly offset by the financial
gains that result from a higher proportion of patients receiving clot
busting drugs and the reduced stroke-related disability and subsequent
reduced need for rehabilitation, nursing home care and assistance at
home."
The results of this economic research have implications on the assignment of financial
responsibility between hub and spoke hospital partners. For instance,
in a network that is principally designed to aid spoke hospitals'
capacity to effectively assess, treat, and admit more patients with
stroke, it is the spoke hospitals which benefit economically — and it
then makes sense that the spoke hospitals should contribute to financing the telestroke network system.
The study was conducted by researchers at Mayo Clinic, Georgia Health Sciences University, Analysis Group, and was funded by Genentech, Inc.
Mayo Clinic first used telemedicine technology with the stroke
telemedicine program in 2007, when statistics revealed that 40 percent
of residents in Arizona lacked local stroke experts.
Mayo Clinic was the first medical center in Arizona to do pioneering clinical research
to study telemedicine as a means of serving patients with stroke in
non-urban settings, and today serves as the "hub" in a network of 12
"spoke" centers. Since the telestroke program began more than 1,500
emergency consultations for stroke between Mayo stroke neurologists and
physicians at the spoke centers in Arizona have taken place. Beyond Arizona, Mayo Clinic
Telestroke is represented nationally, with hub and spoke networks
already in existence in Florida and in a development phase in Minnesota
and Mayo Clinic Health System.
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