Essay Example on According to the Centers for Disease Control and Prevention

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According to the Centers for Disease Control and Prevention CDC in 2015 stroke was the fifth leading cause of death in the United States US Those who survive are classified among the highest and most serious long term disability patients Stroke is a disease with a high social and economic impact Wechsler et al 2013 The incidence of stroke is about 800 000 cases per year Roger et al 2012 It has been estimated that the total cost of strokes in the U S was 38 6 billion in 2009 taking into consideration the expenses related to healthcare services medication and lost productivity Kulscar Gilchrist George 2014 In recent years treatments administered within the first few hours by a qualified specialist have shown to reduce mortality and improve prognosis in stroke patients by 30 The first 60 minutes after the onset of stroke symptoms is crucial to begin treatment in order to minimize long term disability or avert stroke death Bresnick 2013 It has been reported that in 2005 that nearly 1 1 million stroke survivors had reportedly struggled with performing basic daily activities Kulscar et al 2014 According to the 2013 Population statistic Census approximately 19 3 of the U S population lives in rural areas many of which lack permanent presence of an expert neurologist Telemedicine for stroke also known as telestroke helps to bridge the gap between treatment time and shortage of neurologists in rural underserved areas Nagao Koschel Haines Bolitho Yan 2011 



Neurologists with stroke care expertise usually located in urban areas are not always feasible destinations for Emergency Medical Services EMS transporting stroke patients from rural areas Based on a 2009 national study of EMS response times it was estimated that only 22 of the U S population in a rural area lived within a 30 minute drive to a neurologist staffed medical facility Albright et al 2010 In a broad scope telemedicine is the practice of medicine at a distance assisted by the electronic transfer of data through audio and video Kazley Wilkerson Jauch Adams 2012 Telestroke is a cost effective delivery method that enables neurologists to provide life saving treatment to stroke patients in rural areas that lack access to physicians with adequate stroke knowledge and expertise Under the telestroke model neurologists are enabled to communicate using digital technology with on site physicians who are treating patients at facilities that do not have adequate stroke expertise An off site neurologist can perform neurological assessments of a patient evaluate brain imaging and aid bedside healthcare providers in diagnosis and treatment including administering IV tPA which is a clot busting drug that reduces mortality and long term disability Schwamm et al 2009 Business and Health Administration Association Annual Conference 2016 Page 116 Physician administered tPA is the only Food and Drug Administration approved treatment for ischemic strokes By dissolving the clot and increasing blood flow to the brain tPA that is given between three to four and a half hours from the onset of symptoms can improve the recovery of a stroke Adeoye et al 2011 According to the American Heart Association telestroke is about developing a network connection through audiovisual systems that allows physical examination of the patient from a distance and evaluation of complementary tests such as a CT or MRI The neurologist referral center can better identify those patients who will benefit from the transfer and indicate the appropriate treatment saving crucial time in this pathology Timpano et al 2013 The purpose of this research was to explore the shortage of neurologists in rural areas to determine if telestroke can impact stroke intervention in rural hospitals 



METHODOLOGY The primary hypothesis of this study was how the use of telestroke in rural health facilities can increase quality outcomes of stroke intervention in hospital emergency rooms if neurologists are not available The method for this study was a qualitative study using literature review The Marshall University Drinko library in Huntington West Virginia was used for full text articles utilizing the PubMed EbscoHost WorldCat and ProQuest databases Google Scholar was used when articles could not be located through the above mentioned data bases Terms included in the search consisted of telestroke AND rural hospitals OR hospital reimbursement OR neurologist OR shortage of neurologists in rural areas OR cost OR outcomes Reputable websites of CDC United States Census Bureau American Heart Association and American Telehealth Association were also used Articles were limited to the English language 38 articles were selected for this research Further a semistructured interview with an expert clinician well versed in emergency medical treatment of strokes in a regional ER that utilizes a telestroke hub model added to the data collection was performed This clinician will be referred to as Expert in ER telestroke throughout the review This search was completed by SM JAP and AS and validated by A

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