New research shows teleproctoring between advanced nurse practitioners and vascular neurologists in a certified stroke center is a feasible method of delivering stroke care in rural hospital settings, according to findings presented at the International Stroke Conference 2022.

Researchers evaluated the use of a web-based, HIPAA compliant, teleproctoring platform for evaluation of etiology of ischemic stroke by advanced nurse practitioners in this ongoing project that could help expand care in rural-based hospitals.

In this project, Prisma Health Tuomey, a rural-based spoke hospital in South Carolina, used a web-based, HIPAA compliant, telemedicine platform (Zeriscope) to provide a live interactive video stream to Prisma Health Richland, an urban-based hospital and certified Comprehensive Stroke Center 45 miles away.

“Zeriscope uses a mobile exam headset, comprised of a camera attached to a cellphone and an audio headset, to provide two-way audio and visual communication between an APP and a board-certified vascular neurologist,” wrote Alex Vezzetti, Prisma Health-Midlands, Columbia, South Carolina, of how the technology works.

In-patient care was provided with full access to neuroimaging, vascular imaging, cardiac imaging, and long-term monitoring. Researchers noted that patients evaluated in the emergency room for TPA and thrombectomy were transferred to the stroke center and excluded from this assessment.

A total of 52 ischemic stroke and TIA patients were evaluated and treated in a 4-month period from April to August 2021. Of note, 52% of patients were African American, 69% were male, and the median age was 67.8 years.

Using TOAST criteria, all patients underwent a standardized stroke work-up to determine stroke etiology and were treated with best medical management per secondary stroke prevention guidelines.

Thus far, no patients involved in the project have experienced complications, readmission, or transfer to a stroke center.

Vezetti et al determined tele-proctoring is a feasible method of delivering stroke care in a rural hospital that has not been previously implemented.

“The use of Zeriscope was practical and effective in determination of ischemic stroke etiology and implementation of best practice guidelines,” they concluded.

Source:

Vezetti A. Project TURNIP: Teleproctoring of Rural Stroke Patients With Advanced Nurse Practitioner.Presented at: International Stroke Conference