Illustration by Matthew Woodson
Moments matter in the timeline of a stroke. Doctors must make lifesaving decisions with speed. Some of those decisions, like whether to administer a clot-busting drug that could restore brain function, come with potential deadly consequences. Giving the drug at the wrong time or to a person not actually experiencing a stroke could mean excessive bleeding and possibly death. In rural areas, some doctors are less confident about making that tough decision. Now, they can receive the specialized guidance of a neurologist—via robot.
In January, Washington University School of Medicine and Barnes-Jewish Hospital began using telemedicine to deliver top-quality medical care to some of Missouri’s most remote areas. At one time, for instance, stroke victims at Parkland Health Center in Farmington were often transported roughly 75 miles to St. Louis via helicopter for neurological care. By partnering with local specialists and using advanced medical equipment, however, medical experts there can now make more confident decisions without sending patients so far from home. “The robot extends our reach,” says Dr. Jin-Moo Lee, director of the cerebrovascular disease section of Washington University School of Medicine’s neurology department. “We’ve expanded our range of expertise to rural areas that need the confidence to make tough medical decisions.”
Here’s how it works: A person who shows signs of a stroke is admitted to the hospital. When doctors in Farmington are not sure whether to administer the clot-busting drug, they call a St. Louis neurologist and wheel a standing robot to the patient’s bedside. The robot—equipped with a display screen and two-way camera—allows a remote neurologist to interact with the patient. The doctor then runs through a set of tests, checking for stroke symptoms; the neurologist can do everything but touch the patient. Nurses in Farmington help maneuver patients, shine a light in their eyes, and check their vitals. The St. Louis–based neurologist can then give the go-ahead to administer the drug or explore other options.
Before telemedicine, Farmington doctors only administered the drug once a twice or year, says Lee; now, they’re saving patients with the drug about once a month.
“Before, our doctor had to paint the picture for the neurologist,” says Kathy Ferguson, nurse manager at the Farmington Health Center. “Now they can actually see them. Instead of taking the patient to the neurologist, we get to bring the neurologist to them.”
