Doctors go global

22:32, Mar 02 2013

Doctors could soon treat suspected stroke patients at Palmerston North Hospital via the internet - from more than 18,000km away.

The reciprocal arrangement with Scottish physicians at Wishaw Hospital in Lennoxshire would be a world first, said MidCentral District Health Board neurologist Anna Ranta.

If successful, the pilot project could lead to "telestroke" being used at other lower North Island hospitals, such as Wellington and Hawke's Bay, by early next year.

Telestroke has been used within Australia and the United Kingdom, but never between countries.

A Palmerston North medical registrar and nurse will brief a Scottish specialist by phone, before providing scans and then linking up by video so the patient can be assessed.

The specialist will diagnose and recommend a course of thrombolysis treatment, which dissolves blood clots and enables blood flow to return to the brain.


Stroke patients need to be treated within 4 hours of the onset of symptoms in order to prevent parts of the brain from dying.

Because of this urgency, Ranta and the other stroke specialist at Palmerston North Hospital are currently unable to be out of town at the same time.

"The reason why it's particularly relevant for a medium-sized hospital like Palmerston North is that we are big enough to have a very good stroke service and experience on site, but not big enough to provide a consistent 24-hour roster," Ranta told the Star-Times.

The Scottish hospital is grappling with the same staffing problems, she said.

MidCentral's chief medical officer, Ken Clark, said employing more neurologists was always an option - the hospital will soon have three - but the service would mean additional support was always on hand.

"The key here is having the right expertise any time, day or night.

"There's also the element of support of our own specialists.

"There's not many of them and they have to cover huge areas."

Clark said the service was as safe as having a neurologist physically in the room.

"People do worry in some of these circumstances about where the results are going, who the doctors involved at the other end are, but all of that side of things has been done to a very satisfactory level."

Patients will be asked to sign a consent form to take part in the project and a local neurologist will be on call as back-up should they be needed.

The international project has taken about 18 months to get off the ground, Ranta said.

Sharing confidential information about patients via the internet has meant new systems had to be created, such as a "virtual tunnel" that will allow doctors to see scans without having to email them and a secure video conferencing link similar to Skype.

Government agencies on both sides of the world have been involved, as have the Medical Council of New Zealand and the General Medical Council in Britain.

The doctors involved do not need to be registered in the overseas jurisdiction, Ranta said.

She expects about two cases per month to be referred to the Scottish specialists.

Sunday Star Times