Telemedical network speeds treatment for stroke patientsDoctors in Germany are conducting long-term tests of innovative telemedical and therapy options for treating stroke patients as quickly as possible. Among the approaches being investigated and refined are mobile stroke units, known as STEMO, and TEMPiS or the "flying interventionalists."
TEMPiS stands for TeleMedical Project for Integrated Stroke Treatment. It involves specialized, primarily urban stroke therapy centers and at least 11 regional hospitals in southeastern Bavaria, a digital network, stroke experts – and helicopters to get the professionals to where they are needed. Program initiators say TEMPiS is unique to Germany and is the world's largest telemedical stroke network as well.
Time is vital in treating stroke patients. STEMO diagnosis and treatment starts while stroke sufferers are on the way to the hospital. Its main aim is to determine if a stroke has indeed occurred. If so, thrombolysis may be used to dissolve the clots causing the stroke. Studies have indicated that patients in the STEMO program are six times more likely than other patients to receive therapy vital to nerve cell survival within the first hour of treatment.
If thrombolysis fails surgery to remove the clot, known as a thrombectomy, may be required. Rather than bringing a patient to the city for treatment, the TEMPiS system works to ensure that experienced and specialized neuroradiologists are flown by helicopter to perform the surgery at one of eleven regional hospitals. Before they even arrive, patients are being prepared. The "interventionalists" and their teams use video conferencing and telemedical transmissions of CT images to coordinate and speed their efforts. Researchers have found that compared to conventional ambulance services, the TEMPiS system shortens the time it takes for a patient to receive treatment by well over an hour.
Doctors in Bavaria have been gathering a broad range of data on the system since its inception in 2003. Currently, the state health insurance industry is financing a trial in which the "flying interventionalists" are available for 26 weeks of the year. Otherwise, stroke patients will be taken to treatment centers in an ambulance. After six months, an interim assessment will be made.
If the results show that TEMPiS brings improved outcomes, the system could certainly be applied outside of Germany as well. In places with far flung populations, such as Australia, Saudi Arabia, Canada, or parts of the US, the innovative system devised in Germany could bring life-saving treatment to stroke victims.