iStroke
By Kerry Ludlam
Eric Anderson and colleagues tested the effectiveness of the Apple iPhone 4 with FaceTime software to diagnose and determine the severity of a stroke from a distance.
When a person is experiencing a stroke, every second counts. Of the nearly 800,000 Americans who have a stroke each year, however, many do not have quick access to acute stroke care.
With that in mind, third-year Emory neurology resident Eric Anderson set out to find a quick and economical way to diagnose and determine the severity of a stroke from a distance. In a study recently published in the Journal of Stroke and Cerebrovascular Diseases, Anderson and colleagues tested the effectiveness of the Apple iPhone 4 with FaceTime software to do so.
The study included 20 patients who were admitted to Grady Memorial Hospital for acute stroke. For each patient, a physician performed an assessment at the patient’s bedside while transmitting it over an iPhone using FaceTime software to a second physician participating in the examination remotely. Both physicians assessed the patient using the NIH Stroke Scale (NIHSS), a 15-step tool that provides a quantitative measure of stroke-related neurologic deficit. Neither physician had information on the patient’s condition prior to examination, and both were blinded to each other’s scores. The average NIHSS scores for each patient were strikingly similar between the bedside and remote physicians.
"In 10 out of the 15 measures on the NIHSS, there was very little difference between the scores given at the bedside and those given remotely through iPhone technology," says Anderson. "More important, this shows an important technology for patients who do not have quick access to a vascular neurologist and stroke team."
Although other forms of telemedicine have been available for stroke assessment and care for more than a decade, the start-up costs have proved to be too burdensome for smaller or more rural hospitals, which are the places that need telemedicine options the most.
"In the past, a lot of telemedicine systems have included mobile robot units, entire computer systems, and professional cameras," says Anderson. "The start-up costs for these types of things are enormous. This study certainly shows that we don’t need expensive or complicated systems. We can do this with a cell phone that is readily available and entirely portable. Overall, this approach drops the bottom line for everyone and allows patients to have access to care that is affordable."
Anderson said the next step is to move his research beyond proof of concept to looking at outcomes and how this technology can help end the delay that often comes when patients are miles away from needed specialists.
"We’re certainly continuing down the road of expansion," Anderson says. "Now that we’ve shown the technology works, we can look at how it affects patient outcomes. Looking at the time to treatment and time to examination can be a real clincher, especially with a disease where time is such an important factor."
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