Speed Again Equals Success for Kaiser Permanente

Kaiser Permanente hospitals in Northern California are delivering clot-busting medication to new stroke patients more than twice as fast as the national average, notes a release issued to media this week.

We’re told that this follows the regionwide adoption of an integrated telemedicine program, according to new research published Dec. 15 in the journal Stroke.

This is the among the first peer-reviewed, published studies to show how the successful implementation of standardized treatment protocols and telemedicine for acute ischemic stroke in a large, integrated system of hospitals can dramatically reduce the time it takes to start critical treatment.

“When a stroke happens, minutes matter,” said lead author Mai Nguyen-Huynh, MD, MAS, vascular neurologist and research scientist with the Kaiser Permanente Division of Research. “Faster treatment with intravenous r-tPA, which dissolves the stroke-causing clot and restores blood flow to the brain, is strongly associated with better functional outcomes for stroke patients.”

Intravenous r-tPA, also known as alteplase, is the only medication approved by the Food and Drug Administration to treat acute ischemic stroke.

With the Stroke EXPRESS program (EXpediting the PRocess of Evaluating and Stopping Stroke), all Kaiser Permanente emergency departments in Northern California were equipped with telestroke carts, which include a video camera and access to scans and tests results, enabling the stroke specialist to conduct a patient’s neurologic physical exam even when they are many miles away.

Telemedicine was integrated into a complete reorganization of how acute strokes are managed in Northern California, said co-author Jeffrey Klingman, MD, chair of chiefs of neurology for Kaiser Permanente Northern California.

“Processes that used to happen sequentially during a stroke alert, one after another, are now happening at the same time, allowing us to quickly, safely and confidently provide evaluation and treatment with intravenous r-tPA to stroke patients who can benefit,” he added.

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