NIHD tele-neurology program helping potential stroke patients beat the odds

Northern Inyo Healthcare District's partnership with Sevaro has enhanced stroke care, benefitting more than 190 local patients. The team’s swift delivery of blood clot medication surpasses national standards. Here, members of Northern Inyo Hospital’s Emergency Department team take a virtual meeting with Sevaro’s Dr. Sam Saha. From left: Department manager Wendy Derr, Dr. Saha (on screen), and NIHD's Chief Medical Officer and Emergency physician, Dr. Adam Hawkins, and Emergency physician Dr. Samantha Jeppsen. Photo by Barbara Laughon/Northern Inyo Healthcare District

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Strokes can be terrifying. For patients experiencing the sudden onset of double vision, one-sided paralysis, or the inability to communicate, it is scary and confusing. To make matters worse, treating strokes (cerebrovascular accidents or CVAs) is complex and constantly changing in medical research. When someone is having a stroke, every minute counts. As the saying goes, “time is brain.”

Because of these challenges, Northern Inyo Healthcare District invested in a tele-neurology program. This program gives patients immediate access to board-certified neurologists who can help manage stroke care in real time.

NIHD’s clinical leadership recognize that patients with stroke-like symptoms need to see a neurologist, a doctor who specializes in brain and nervous system disorders, as soon as they arrive at the Emergency Department.

To achieve this in an innovative and resource-minded manner, NIHD partnered with Sevaro, a virtual neurology consulting company. Sevaro aims to provide expert neurological care through data-driven telemedicine, empowering patients with better access by breaking down geographical barriers and improving lives through innovation.

Sevaro started providing virtual care to NIHD patients through the Emergency Department, ICU, and inpatient wards in May 2023. Since then, NIHD’s neurology team at Sevaro has helped local medical staff deliver care to more than 190 patients.

Quick access to a board-certified neurologist is incredibly valuable for our local doctors. “It’s amazing that our patients can be evaluated in real-time by a specialist who has had years of training in treating strokes,” says Dr. Samantha Jeppsen, Chair of the NIHD Emergency Department. It allows us to give our patients the best chance of experiencing a positive outcome after suffering from a stroke.”

The most important decision for a doctor treating a stroke patient is whether the patient would benefit from powerful medications called thrombolytics. These medications break up clots in the brain’s blood vessels, restoring blood flow and improving the symptoms of a CVA or stroke. Thrombolytics are powerful and can save lives. However, they can also cause adverse reactions, such as spontaneous bleeding. It is standard of care for this decision to be made by a neurologist, in real time.

Thanks to NIHD’s partnership with Sevaro, patients at the Emergency Department can now expect evaluation by both a board-certified ER physician and a board-certified neurologist within minutes of arriving via state-of-the-art telemonitoring.

The NIHD Emergency Department has a streamlined “code-stroke” workflow to identify patients with stroke symptoms quickly. This allows immediate action to administer thrombolytic medication to eligible patients as soon as possible.

Again, “time is brain.” The sooner physicians address a stroke-causing blood clot, the better the chance of a positive patient outcome, including regaining impaired functions. This measurement, called “door-to-needle time,” tracks care from a patient’s arrival at the ER to receiving the IV thrombolytic medication.

The American Heart Association recommends a door-to-needle time of less than 60 minutes. Since NIHD’s tele-neurology program began, the average door-to-needle time has been less than 45 minutes, saving lives and reducing the long-term effects of a stroke.

“We are thrilled to partner with Northern Inyo Hospital, as they have truly demonstrated their commitment to their community by enhancing stroke and neurological care,” says Dr. Rajiv Narula, Sevaro’s Chief Executive Officer. “The clinical leadership team at NIHD -- exemplary leadership -- showcases the institution's dedication to providing reassurance to families in the community, knowing that their loved ones will receive top-notch neurological care at Northern Inyo. When time matters, Sevaro's technology enables some of the country's best neurologists to be available for patients at Northern Inyo within 45 seconds or less, around the clock.”

Although Bishop and the surrounding communities of the Eastern Sierra are beautiful and offer an unparalleled quality of life, their remote location presents unique challenges for healthcare. NIHD’s tele-neurology program has helped overcome these challenges, resulting in better medical care and outcomes for our patients and communities.

If you or loved ones have questions or concerns about stroke risk factors and how to minimize your risk, NIHD offers comprehensive primary care through our Rural Health Clinic. However, if you or a family member experience sudden one-sided weakness, facial drooping, difficulty speaking, balance issues, numbness, or vision changes, seek emergency care immediately. Remember, time is brain!