Some very useful telemedicine applications are emerging and being evaluated, particularly those utilizing smart phone apps. The Mayo telstroke program in Arizona was used as a testbed to assess one such app, as discussed in a recent article (see: Mayo telestroke study affirms accuracy of ResolutionMD smartphone app). Below is an excerpt from it:
The evidence is building that smartphones are suitable for remote viewing of medical images by consulting specialists. The latest comes from the Mayo Clinic Telestroke Network in Arizona, which found that the ResolutionMD Mobile smartphone app [a diagnostic medical image viewer]...was adequate for evaluating remotely located stroke patients.“CT head interpretations of telestroke network patients by vascular neurologists using ResolutionMD on smartphones were in excellent agreement with interpretations by spoke radiologists using a picture archiving and communications system and those of independent telestroke adjudicators using a desktop viewer,” concludes a [recent] study....“Essentially what this means is that telemedicine can fit in our pockets,” Mayo Clinic Telestroke Medical Director Dr. Bart Demaerschalk [said] “For patients this means access to expertise in a timely fashion when they need it most, no matter what emergency room they may find themselves.” Mayo Clinic neurologists in Phoenix can remotely consult with emergency departments at 12 rural hospitals, mostly in Arizona, that have fixed telemedicine platforms or telemedicine robots. Typically, the stroke specialists have face-to-face video chats with remote ED physicians and view brain scans on a standard desktop or laptop PC to look for signs of hemorrhage or blocked arteries. For this study, the Mayo neurologists and radiologists at Yuma (Ariz.) Regional Medical Center compared brain scans for 53 patients on traditional PACS displays and with the FDA-cleared ResolutionMD app. The reviewers were in agreement on 92 to 100 percent of what are considered the most important radiological features, according to the report. Quick diagnosis of stroke and administration of clot-busting drugs can save lives and the remote nature of the telestroke interventions help prevent costly, dangerous patient transfers by ambulance or airlift from rural facilities to urban trauma centers. Being able to make accurate diagnoses from mobile devices can save even more precious time when on-call neurologists are not in front of a PACS station.
The most important news here is that the ResolutionMD Mobile smartphone app was deemed equivalent to traditional PACS displays for the interpretation of CT head images of patients being evaluated for a stroke. Time is of the essence for possible stoke patients who derive great benefit from the injection of clot-busting drugs such as tissue plasminogen activator (TPA) within 4.5 hours. However, the sooner the better in terms of its administration (see: Stroke Treatments and Drugs). Clearly this finding is of great importance for small rural hospitals that may have limited or no access to neurologists and neuroradiologists, particularly on an urgent basis.
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