Telestroke: How to Save a Life

1. Kathy Blacker Network Director Cardiac and Stroke Networks in Lancashire and Cumbria Gus Hartley Programme Lead ICT Infrastructure NHS North (North West) Head of North West Shared Infrastructure Service (NWSIS) Telestroke: How to Save a Life A celebration of those ‘light bulb moments’ that are transforming patient experience and care across the North West NHS Q.I.

2. Background Stroke Statistics • Stroke is the largest cause of complex disability in adults • Stroke costs the UK over £8.2 billion every year • Every five minutes someone suffers a stroke in the UK • Thrombolysis can benefit some patients with stroke • In 2008, only two hospitals in Lancashire and Cumbria offered treatment, which was only available between 9am-5pm, Monday to Friday • Rural geography and limited stroke clinician numbers posed a huge problem • The challenge was to find a way to deliver best practice to all patients suffering a stroke in our area

3. Model of Collaboration Patient Service Provider Clinical Experts Technology Specialist • Virgin Media Business developed a close working relationship with the NHS in Cumbria and Lancashire, Southport and Macclesfield • Delivered a solid ICT and Technology foundation across Lancashire, ‘the core of the service’ • Telestroke workstream developed in conjunction with clinical, operational, and technology staff • To meet the challenge of Out Of Hours (OOH) care for critical conditions – stroke • VMB worked to understand how the solution might be delivered in collaboration with partners • Coordinated the activity • Designed the solution • Leveraged existing investment • Delivered a first in a fully managed, monitored, maintained Telestroke solution • Clinicians simply use the system

4. Telestroke – The Solution • High Definition (HD) Telecarts, cameras, screens and clinician laptops • Implemented across the Cumbria, Lancashire, Southport and Macclesfield COIN Networks in nine hospitals • Business-class broadband and IPVPN router in clinicians homes (NOT over internet) • Supports HD audio/visual conferencing between clinician and the patient • Displays critical triage information, CT Scan and vital signs • Post assessment patient information distributed via NHSmail to hospital • Secure digital recording available • Team of 18 stroke clinicians provide 24/7 cover all year round

5. Cumbria & Lancashire Stroke Network - What has been Delivered Financial benefit Service delivered Patient benefit • 449 Advice calls • 397 Telestroke assessments • 167 patients thrombolysed – who would not have received treatment • Received best care 24/7 • Patient receives specialist assessment at the bedside without transfer in small rural hospitals • Improved outcomes through reduction in death and long-term disability • NHS and social care savings modelled at over £7 million due to reduction in long-term disability • Delivered by existing workforce with shared rota across 9 hospitals 2 1 3

6. Video as a Service (VaaS) • Provided as a central hosted resource to support clinical telemedicine services. • Current Services: • Telestroke • Renal Home Dialysis • Cancer Networks • Speech and Language Therapy • Under Implementation: • Vascular • Burns • Prison medicine

7. Telestroke Live

8. Questions?