Telemedicine Background

• Until 1996, there was no acute treatment available for stroke. That year the US Food and Drug Administration (FDA) approved the drug, tissue plasminogen activator (t-PA), for use in acute ischemic stroke patients, if given within 3 hours of symptom onset. This drug is a clot busting drug.
• Even though t-PA was made available and proven effective, there were still problems in treating acute stroke patients: lack of organized infrastructure, difficult 24/7 coverage by neurologist willing to treat hyperacute stroke patients and ER physicians were reluctant to take on the burden of treating patients with t-PA, given an intracerebral hemorrhage rate of 6.4%.
• The widespread use of t-PA has been extremely low. The most generous estimates of acute stroke treatment are between 2% to 5%, both in Colorado and across the United States.
• In 2001, Colorado reported iv-t-PA treatment rates as low as 1.4%.
• In 2005, members of Blue Sky Neurology, Swedish Medical Center and the Colorado Neurological Institute made plans to deploy telemedicine cameras to the rural and frontier areas of Colorado.
• In January 2006, the Colorado Neurological Institute was awarded a grant from the Colorado Department of Public Health and Environment to place telemedicine cameras in 6 rural hospitals.
• Swedish Medical Center (SMC) provided support for neurology coverage for the CO-DOC system, a medical director to lead the project, 24/7 access to expert stroke care, and AirLife transport through the Swedish ONE-Call hotline.
• While the grant cameras were being placed, two additional hospitals joined the telemedicine network increasing the network to eight (8) cameras with Swedish Medical Center being the hub station as a JCAHO certified Primary Stroke Center.
• Blue Sky Neurology provided the 24/7 acute stroke coverage for the grant sites. In March 2007, the Caring for Colorado Foundation provided a grant to hire a Project Manager, to expand sites and services, and to help make the project sustainable.
• That brings us to TODAY

CO-DOC Telemedicine Today

• We currently have nine (9) hospitals in our telemedicine network: Kremmling Memorial Hospital District, Kremmling; Vail Valley Medical Center, Vail; Yuma District Hospital, Yuma; Southeast Colorado Hospital, Springfield; Mt. San Rafael Hospital, Trinidad; Swedish Medical Center, Englewood; Gunnison Valley Hospital, Gunnison; Southwest Memorial Hospital, Cortez; North Suburban Medical Center, Thornton.
• We have one (1) contract in progress: North Colorado Medical Center, Greeley.
• We are currently providing Stroke Education twice a year to all of our host hospitals for Hospital Staff, EMS and the Community.
• We are also exploring other opportunities to develop parallel stroke telemedicine projects with hospital systems, adding other applications (i.e. neurotrauma, neurosurgery and pediatrics), and distance learning.

COLORADO, CO-DOC Telemedicine Host Hospitals: Kremmling Memorial Hospital District, Kremmling; Vail Valley Medical Center, Vail; Yuma District Hospital, Yuma; Southeast Colorado Hospital, Springfield; Mt. San Rafael Hospital, Trinidad; Swedish Medical Center, Englewood; Gunnison Valley Hospital, Gunnison; Southwest Memorial Hospital, Cortez; and North Suburban Medical Center, Thornton.