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NAME OF NETWORK
Virginia Acute Stroke Telehealth Network (VAST)
Name of Grantee
Virginia Department of Health, Office of Minority Health and Public Health
Policy
Principal Investigator/Project Manager
Cynthia Barrigan, Executive Director, Virginia Telehealth Network
Address PO Box 2356 Centreville, Virginia 20122
Phone 703-802-4878
Fax 1-888-205-0114
Organizational Website www.ehealthvirginia.org
E-mail cbarrigan@ehealthvirginia.org
Project Purpose
Virginia’s incidence and mortality rates for stroke are among the
highest in the nation – a vexing problem for the State’s health
care providers. The Institute of Medicine of the National Academy of Science
and the American Stroke Association has concluded that the fragmentation
of stroke systems of care contributes to the magnitude of this health
problem—especially in rural and underserved communities.
The American Stroke Association, a division of the American Heart Association,
says that a community’s stroke system of care must include certain
fundamental components ((Stroke. 2005; 36:690.) http://stroke.ahajournals.org/cgi/content/full/36/3/690):
- Primary prevention
- Community education
- Notification and response of emergency medical services
- Acute stroke treatment
- Subacute stroke treatment and secondary prevention
- Rehabilitation
- Continuous Quality Improvement Initiatives
The lack of focused health information technologies (HIT) that enable
health information exchange (HIE) and the delivery of remote telehealth/telemedicine
services (TH/TM) are partially responsible for serious disruptions in
continuity of care as stroke patients move from one level of care and
care provider to another throughout Virginia’s health care system.
Further, the lack of integrated HIT capabilities that enable the rapid
and efficient transfer of patient data and digital images impedes the
timely diagnosis and treatment of stroke victims.
The purpose of the Virginia Acute Stroke Telehealth Network (VAST) is
to design, development, test and evaluate a model stroke network across
the Central Shenandoah Region. HIT will be implemented at Bath Community
Hospital—a critical access hospital-- and its supporting hospitals
as part of a regional stroke quality improvement initiative. The intent
of this project is to examine the first four components of the stroke
continuum of care—Prevention, Community Education, EMS Notification
and Acute Treatment—and introduce HIT solutions--along with other
interventions-- to strengthen , improve and more tightly integrate these
components of the stroke systems of care. It is envisioned that this model
would be considered for state-wide adoption.
Primary Objectives
- Increase awareness of stroke signs and symptoms and best practices
in stroke care.
- Improve the stroke EMS response.
- Accelerate time to diagnosis and treatment of acute stroke
Outcome Measures/Expectations
Prevention/Community Education
- Develop and implement a centralized stroke website for Virginia (virginiastrokenetwork.org)
that patient/providers can use to access information on national and
state-level stroke initiatives, stroke policy, best practices, VAST,
and receive on-line stroke education and training.
EMS Notification and Response
- Develop a Stroke EMS Plan for the Region
- Develop electronic stroke training materials and standardized protocols.
- Implement a web-based learning management system.
- Deliver on-line stroke training to EMS providers.
Acute Treatment
- Deploy critical tele-stroke infrastructure which includes: the RP-7
Remote Presence System to facilitate remote neurology stroke consults;
the implementation of PACS and integrated tele-radiology solutions to
enable the digital capture, transfer, archiving and on-going sharing
of CT scans for rapid interpretation across the network; and improvements
to the existing CPSI electronic medical record system for enhanced medical
documentation of stroke in the Emergency Department.
Service Area
The service area for the project spans the entire Central Shenandoah
Valley---- with a special emphasis on Bath County which is a designated
Medically Underserved Area (MUA). The Central Shenandoah Valley
Region is located in the middle of the historic and scenic Shenandoah
Valley in west-central Virginia. It has a land area of 3,439 square miles;
the Region is home to some 246,400 persons. Geographically, the Region
is the largest health planning district in the state.
The Region is comprised of five counties (Augusta, Bath, Highland, Rockbridge
and Rockingham); five independent cities (Buena Vista, Harrisonburg, Lexington,
Staunton, and Waynesboro); and eleven towns (Bridgewater, Broadway, Craigsville,
Dayton, Elkton, Glasgow, Goshen, Grottoes, Monterey, Mt. Crawford and
Timberville).
According to the U.S. Census, Bath County’s population is approximately
4,814. Persons over age 65 make up 19.4% of the county as
compared to 11.4% of the State’s population. The median household
income in Bath County (2000) was $38,145 as compared to the State median
of $51,103.
Network Members
Organization Name /
Provider Type |
County/
Parish |
Address |
City, |
State |
Zip Code |
Bath Community Hospital
/ Critical Access Hospital |
Bath |
P O Drawer Z |
Hot Springs |
VA |
24445 |
Contact |
Phone |
Email |
Debbie Lipes, CEO |
540-839-7059 |
bcchdl@bcchospital.org
|
Organization Name /
Provider Type |
County/
Parish |
Address |
City, |
State |
Zip Code |
Rockingham Memorial Hospital- Community
Hospital |
Rockingham |
235 Cantrell Avenue |
Harrisonburg |
VA |
22801 |
Contact |
Phone |
Email |
Dr. Dennis Carroll, Chief Medical Officer |
540-433-4100 |
dcarroll@rhcc.com |
Organization Name /
Provider Type |
County/
Parish |
Address |
City, |
State |
Zip Code |
Augusta Medical Center |
Augusta |
78 Medical Center Drive |
Fishersville |
VA |
22939 |
Contact |
Phone |
Email |
Dr. Fred Castello, Chief Medical Officer |
540-332-4251 |
fcastello@augustamed.com |
Organization Name /
Provider Type |
County/
Parish |
Address |
City, |
State |
Zip Code |
University of Virginia / Tertiary Care
Academic Medical Center. |
Albemarle |
1215 Lee Street |
Charlottesville |
VA |
22908 |
Contact |
Phone |
Email |
Dr. Nina Solenski |
434-924-8374
|
NJS2J@virginia.edu |
Organization Name /
Provider Type |
County/
Parish |
Address |
City, |
State |
Zip Code |
Central Shenandoah EMS Council / EMS
|
Augusta |
2312 West Beverly Street |
Staunton |
VA |
24401 |
Contact |
Phone |
Email |
Dr. Asher Brand, Medical Director |
540-886-3676 |
Asher.Brand@gmail.com |
Equipment/Vendors or Collaborative Partners
Vendors
- InTouch Health: RP-7 Remote Presence System: Uses
a mobile robot with live untethered video-teleconferencing capability
and allows a stroke neurologist to immediately initiate an assessment
from any location using a remote control joystick to pilot the robot
in the remote environment without assistance from the remote community
ED.
- Computer Programs and Systems, Inc (CPSI): Electronic
Forms Module: Replaces paper-based patient data and care forms
with user-defined electronic ones. Displayed and completed on-line using
Microsoft's Internet Explorer, the module's forms are easy to use and
can be customized to meet such needs as ED triage, trauma, assessments,
modality worksheets, consent for treatment, information release requests,
transfers, etc.
- PACS Vendors being evaluated include DR Systems, CPSI and
Carestream.
Collaborative Partners
- American Heart Association (Mid-Atlantic Affiliate)
- Edward Via Virginia College of Osteopathic Medicine (VCOM)
- Virginia Department of Health - Division of Chronic Disease &
Control
- Virginia Department of Health – Office of Minority Health
and Public Health Policy
- Virginia Health Quality Center
- Virginia Stroke Systems of Care Collaborative
- Virginia Telehealth Network
- Winchester Medical Center - Valley Health
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