National rollout of a web based telemedicine stroke care service: REACH 2.0

Stroke care in the US and in the world is fragmented and mostly unavailable in rural areas. The primary reason for poor stroke care is the lack of neurological expertise in rural hospitals. While existing point-to-point telemedicine systems work in some cases, there is an overwhelming need to remove the geographic penalty associated with acute stroke care and make it readily available in rural, suburban and urban hospitals. REACHMDConsult, Inc. has leveraged ubiquitous tools and communications infrastructure to allow 100% web based remote diagnosis and evaluation of acute ischemic stroke and other acute medical conditions. This service is called Remote Evaluation of Acute isCHemic stroke (REACH). Existing telemedicine and telestroke systems primarily focus on a camera to allow remote neurologists to examine and diagnose stroke patients. REACH is typically deployed in a hub and spoke network of hospital and provides integrated 2-way audio video capabilities as well, but also allows neurologists to use database powered decision support algorithms and tools to complete a web based stroke consultation. Neurologists use an intuitive, AJAX powered web user interface to fill out standardized NIH Stroke Scale scores, follow-up items, contraindications and consult comments. The consultation is documented in a real-time, database powered consult report in which can be printed, saved or accessed at any time.