Mayo Clinic extends telemedicine to Navajo Nation

By Erin McCann
10:34 AM

Mayo Clinic has extended its telestroke program to residents of the largest Navajo Nation city who need emergency medical care due to stroke.

As a result of the recent agreement between Tuba City Regional Health Care and the Scottsdale, Ariz.-based Mayo Clinic, officials say the telehealth services will start in Tuba City as early as November.

Tuba City is located in north central Arizona, within the Painted Desert. Some 92 percent of the city's 8,611 residents belong to the Navajo and Hopi tribes.

"This telestroke partnership between our physicians and Mayo Clinic means our Navajo and Hopi patients can now have immediate high-tech, state of the art stroke care," said Joseph Engelken, CEO of Tuba City Regional Health Care.

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Mayo Clinic was the first medical center in Arizona to conduct clinical research to study telemedicine as a means of serving stroke patients in non-urban settings, officials say, and today serves as the hub in a network of 11 other centers, all but one located in Arizona. Tuba City Regional Health Care will become the 12th hospital to be part of the telestroke service from Mayo Clinic.

When Mayo Clinic began its stroke telemedicine program in 2005, officials said research revealed that 40 percent of Arizona residents lived outside an area with immediate stroke expertise. In telestroke care, the use of a telestroke computers located in a rural hospital allows a stroke patient to be seen in real time by a neurology specialist at Mayo Clinic located in Phoenix.

The Mayo stroke neurologist consults via computer screen with emergency room physicians at the rural sites to then evaluate the patient. Patients showing signs of stroke can be examined by the neurologist via computer, smart phone technology, portable tablets or laptops.

In addition to assessment of the patient, the neurologist can view scans of the patient's brain to detect possible damage from a hemorrhage or blocked artery.

Officials say a major benefit of the collaboration is that patients with stroke symptoms who meet the criteria can often be administered clot-busting medications within the narrow window of time necessary to minimize permanent injury to the brain.

"Excellent, capable emergency physicians at Tuba City Regional Health Care can ring the telestroke hotline and be instantly connected with Mayo Clinic's stroke experts," said Bart Demaerschalk, MD, professor of neurology, and medical director of Mayo Clinic Telestroke. "Urgent and immediate virtual care can be provided to patients — collaboration between stroke neurologists and physicians at the remote sites has resulted in 96 percent accuracy in diagnosing stroke."

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In addition to accurate diagnoses, officials say the telestroke program really improves patient comfort, as they no longer have to venture far to see a doctor.

"Telestroke will enhance the quality of care we provide to our loved ones, by providing them with access to specialists without having to leave their family or home," said Joette Walters, Clinical Education Department Manager who oversees the telemedicine program at Tuba City Regional Health Care. "Stroke can be a devastating and life-altering diagnosis, where optimal treatment is contingent on a narrow timeframe, by providing this new service we have the potential to improve quality of life for our loved ones."

To date, more than 1,000 emergency consultations for stroke between Mayo Clinic stroke neurologists and physicians at the spoke centers have taken place. Such comprehensive evaluation techniques, leading to appropriate life-saving treatment for stroke, have resulted in significant cost reductions in terms of ground and air ambulance transfer of the patient to another medical center.

Demaerschalk explains that telestroke technology is not intended to replace face-to-face communication with patients. "But our research strongly suggests that the technology can enhance evaluation and treatment for patients in rural areas, as well as peer-to-peer collaboration among physicians," he says.

It is estimated that more than 45 percent of Americans live more than 60 minutes away from a primary stroke center. If a stroke has occurred, "every minute is precious," notes Demaerschalk.

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The Mayo Clinic Telestroke Network also includes Arizona hospitals in Kingman, Flagstaff, Parker, Cottonwood, Show Low, Globe, Yuma, Bisbee, Casa Grande and Phoenix and a hospital in St. Joseph, Mo.