AR SAVES: Outcomes of a Twenty First Century State-wide Tele-stroke Program

First in the nation for stroke mortality – A standing Arkansas' rural population faces daily. Saturated in healthcare provider shortages, telemedicine technology is employed by this rural state to overcome its alarming rates of healthcare adversity. Telemedicine advocates at the state's Medicaid program, rural hospitals, and only academic medical center renewed an annual $6M telemedicine-driven stroke triage program in Arkansas' rural emergency rooms.

Arkansas SAVES (Stroke Assistance through Virtual Emergency Support) presents an innovative solution to a statewide problem. Without sub-specialty support of a vascular neurologist, many rural emergency rooms treating the potential stroke victim are reluctant to diagnose stroke and administer clot-busting medication. In four years utilizing a hub and spoke model, the program has launched 2 hub sites and 36 spoke sites. Vascular neurologists consult spoke sites through interactive, real-time video, interviewing patients and reviewing CT scans to promptly determine diagnosis.

This around-the-clock telemedicine-based call has increased the administration of tPA(tissue plasminogen activator), a life-saving medication. Since November, 2008 a total of 903 calls were made to AR SAVES with 208 patients receiving tPA.

Public education is critical to enable AR SAVES to fulfill its mission to save the lives of stroke victims and improve their quality-of-life. In general, many stroke victims do not proactively respond to stroke. A well-defined targeted community stroke education campaign strongly emphasizing community awareness is essential to draw more patients into the emergency room during the critical four-and-a-half hour window for treatment.

Tele-medicine is improving the quality-of-life for Arkansas stroke patients through prevention, recognition and treatment of stroke that will facilitate: Prevention and Wellness Across the Lifespan.