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Pristine Blog

How Can We Address the Supply-Demand Imbalance for Neurologists?

Posted by Kyle Samani on Sep 2, 2014 5:19:38 PM

Stroke may be the most tragic of all medical emergencies, because it can so readily be treated.

For each minute a stroke patient is untreated, nearly two million brain cells die. Across ~800,000 US cases a year, these accumulated minutes are a leading cause of death and irreversible disability.

20% of the US population lives outside of major metropolitan areas. And yet, the vast majority of neurologists that can treat strokes with tPA (the only FDA-cleared drug to treat stroke patients) live in major metropolitan areas.

Having a stroke outside of a major metropolitan area is a recipe for disaster.

Only about 5% of stroke patients receive tPA, yet it's estimated that 40-75% are eligible for tPA. So, why are tPA administration rates so low for a drug that's been FDA-cleared since the late 90s? Although there are a number of operational challenges associated with administering TPA, the biggest barrier to tPA administration is lack of access to neurologists who are willing to administer tPA (there is some legal risk associated with administering tPA so many neurologists simply choose not to be on call for strokes).

So how can healthcare enterprises address the supply-demand imbalance? How can health systems get neurologists to patients in need in a timely fashion? Tele-stroke appears to be the best solution. By breaking down geographic barriers, we can dramatically increase the pool of available neurologists for a given patient in need.

Tele-stroke networks are forming around the country. These networks are comprised of hubs (usually accredited Comprehensive Stroke Centers) that are typically located in major metropolitan areas and spokes (located in suburbs or in rural areas). The spokes contract with the hubs who provide tele-stroke coverage to the spokes. The neurologists typically live in the cities and are affiliated with the hubs; as part of their agreements with the major city hospital, the neurologists agree to be available on call to consult with the spokes via tele-stroke technologies.

In the tele-stroke center model, everyone wins: neurologists see patients that they otherwise wouldn't have and generate additional revenue; spoke hospitals keep patients that they would have otherwise had to transfer out; hub hospitals win by guaranteeing a flow of transfers from their spokes; and of course, patients win by getting faster access to the crucial neurologists who will ultimately save their lives.

So, why isn't tele-stroke ubiquitous?

The telemedicine systems that power tele-stroke networks are expensive.

The high cost and large capital expense associated with implementing these systems slows and in many cases prevents formation of tele-stroke networks.

At Pristine, we're breaking down barriers with our cloud-based EyeSight platform. EyeSight is our HIPAA-compliant, cloud-based platform that's dramatically more affordable and easier to implement and use than legacy tele-stroke solutions.

Legacy telemedicine systems are prohibitively expensive, costing tens of thousands of dollars per hardware end-point per year!

At a fraction of the price, Pristine offers a software platform that works with just about any device. Want to use iPads in telestroke? Great. Want to put Google Glass in your ambulances for prehospital care? Even better. Run EyeSight on your existing carts? Sure, go for it!

We're seeing rapid adoption of our technologies for use in tele-stroke and other clinical service lines. Although we're just 16 months old, we already have more than 17 paying clients. One of the key reasons for our remarkable growth has been that we can deliver a turn-key solution in a matter of weeks at $0 capex, with EyeSight.

We are excited to democratize telemedicine, and bring tele-stroke to the masses. Patients deserve it.

Topics: The Pristine Story