A 77-year-old man in The Woodlands gets up from his favorite easy chair but, as he makes his way to the kitchen, suddenly falls on the unforgiving tile floor. Weakness on one side and slurred speech prompt loved ones to make an urgent call to 9-1-1.
Emergency personnel transport the patient to Memorial Hermann The Woodlands Hospital. Evaluation in the emergency room shows the need for a stroke consultation.
Tzu-Ching (Teddy) Wu, M.D., associate professor of neurology, having just consulted on a patient in Beaumont, arrives on the scene. No, he isn’t using time travel, he’s using telemedicine.
McGovern Medical School’s Department of Neurology’s Telemedicine Program for acute neurology serves Memorial Hermann hospitals in Cypress, Katy, Greater Heights, Southwest, Memorial City, The Woodlands, Pearland, and Sugar Land. The telemedicine presence extends beyond the Houston region, including St. Joseph Medical Center, Huntsville Memorial Hospital, UT Health Northeast in Tyler, Baptist Hospitals of Southeast Texas in Beaumont, The Medical Center of Southeast Texas in Port Arthur, Matagorda Regional Medical Center, Tomball Regional Medical Center, Citizens Medical Center, De Tar Hospital in Victoria, and Midland Memorial Hospital in Midland.
The 24/7 acute neurology service allows growing communities outside access to expert vascular neurologists in of the Texas Medical Center and supplements their existing neurology services. Within the last year, the 24/7 service has evolved to address the shortage of neuro-hospitalist coverage in community hospitals by providing routine neurology care to patients admitted to hospitals.
“We offer both emergent and follow-up consultation,” Wu explained. “By using the most advanced technology, we can assess patients and make the right medical decisions that will impact the long-term care of the patients. When it comes to stroke, time is brain, so these timely decisions are vital. By adding inpatient teleneurology to our service, we can make sure the patient is receiving the right post-stroke care as well.”
The fifth-leading cause of death in the United States and second cause of long-term disability, stroke is debilitating to patients and their caregivers.
“Acute ischemic stroke is a treatable disease with IV-tPA, the only proven medical therapy,” Wu said. “We have the capability through telemedicine to bring this treatment to more patients, and we are doing just that.”
The Department of Neurology launched the telemedicine program back in 2010 in partnership with Memorial Hermann’s Mischer Neuroscience Institute to improve overall neurological care in the Southeast Texas region.
Since 2012, the telemedicine team has provided nearly 10,000 consults – increasing the number of consults 790% from 2012 to 2016 –and assisted in over 1,400 IV-tPA cases.
“Another goal was to avoid unnecessary transfers of patients that may not need a higher level of care here in the Texas Medical Center, avoiding unnecessary travel and expense,” Wu added.
If a patient does need a transfer to Memorial Hermann-Texas Medical Center, Wu and the telemedicine team help expedite that.
The telemedicine team has grown to three full-time faculty. Wu now partners with Amanda Jagolino-Cole, M.D. and T.C. Cossey, M.D., both of who trained in the vascular neurology fellowship program at UTHealth. In addition to delivering patient care via telemedicine, Dr. Jagolino-Cole is focusing on training the next generation of physicians to integrate telemedicine in their practice by creating curricula for vascular neurology fellowship, neurology residency, and the fourth-year medical student elective.
The next project for the Telemedicine team, led by program manager Christy Ankrom, is starting up an outpatient neurology clinic that will be staffed by physicians via telemedicine, in Orange, Texas. This will be the first clinic of its kind for UT Physicians and will provide an opportunity to help alleviate patient travel time and accessibility concerns. Should this endeavor be successful, a UT Physicians telemedicine clinic could be possible for other rural areas throughout Southeast Texas.