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Memorial Medical Center, Kaleida Health announce innovative stroke care collaboration

Niagara Falls Memorial Medical Center today became the first urban hospital in New York to partner with a certified, comprehensive stroke care center in an innovative state Department of Health program designed to dramatically improve access to stroke care across the Empire State.

This telemedicine initiative will allow neurosurgeons at The Stroke Care Center at Millard Fillmore Gates Circle Hospital in Buffalo to provide real time consultation and recommend treatment for stroke patients at Memorial's ER1 Emergency Department based on assessment of the patient and review of computed tomography (CT) scans over a secure internet connection. 

This wireless, broadband "telestroke" connection -- which will go live in early October -- will also utilize a webcam that will enable Stroke Care Center physicians to see the stroke patients they are evaluating – even though they'll be 20 miles away.

Millard Fillmore Gates Circle Hospital is JCAHO and New York State Department of Health designated as a stroke center.  The first – and largest in WNY.

"Strokes are the leading cause of death and disability in the United States, with more than 700,000 individuals suffering from recurring, potentially life-threatening debilitating strokes," said New York State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H.  "This innovative telemedicine initiative will significantly reshape and redefine the delivery of stroke treatment and care in New York State."

Modeled after a successful Georgia program known as REACH -- Remote Evaluation of Acute Ischemic Stroke – the New York program was developed to serve rural communities that lack neurologists and stroke specialists.  Memorial, which serves a number of suburban and rural communities north and east of Niagara Falls, partnered with Kaleida Health to purchase the equipment needed to participate.

"Niagara County has the highest cardiovascular disease mortality rate in New York and one of the highest in the United States.  As soon as we heard about REACH, we knew the Greater Niagara region would benefit in a big way from Memorial's participation in this lifesaving effort," said Memorial President & CEO Joseph A. Ruffolo. "Every minute counts when you're suffering a stroke.  The REACH program, and our collaboration with the comprehensive Stroke Care Center at Millard Fillmore Gates Circle Hospital, will save precious minutes and save lives."

Ruffolo said participating in the REACH program has also proven to be "a logical step in the process that Memorial has undertaken to be accredited as a state designated stroke center."

Currently, stroke victims must be transported to the nearest designated stroke facility.  For Niagara County residents, that can entail a lengthy journey across county lines and a significant delay in the delivery of treatment for a disease that claims 157,000 lives each year and is the nation's third leading killer after heart disease and cancer.

By phoning 911 and having ambulances deliver them to ER1 rather than Millard Fillmore Gates Circle Hospital, stroke victims in Niagara Falls, Lewiston, Porter, Wheatfield, Youngstown and neighboring communities will save precious minutes and still receive treatment under the direct supervision of physicians in a comprehensive, state-designated stroke center.

"The telemedicine initiative will allow us to share high end tertiary expertise with outlying facilities," said Andras Vari, M.D., the Chief Medical Officer of Millard Fillmore Gates Circle Hospital.  "This includes real time consultation and the recommendation of treatment for patients who present with stroke symptoms.  As the regional designated stroke center, our physicians and specially trained staff will now have a greater opportunity to improve the quality of care in Western New York."

"This program gives Niagara Falls Memorial the ability to tap into the expertise of the neurosurgeons, neurologists and other specially trained members of the acute stroke team at Millard Gates in real time while they observe our patients," said Dr. Michael Stoffman, Memorial's chief of neurosurgery. "That means stroke patients brought to Memorial's ER1 emergency department will get the care they need and get it more quickly."

In essence, the program will work like this:

• A stroke patient is transported to Niagara Falls Memorial, a designated "spoke" hospital, by ambulance
• The ER1 emergency department contacts Millard Fillmore Gates Circle, the "hub" hospital, which then contacts its on-call neurologist.
•  The neurologist at Millard uses a laptop computer with wireless service to log on to the REACH system
• An audio and visual link is then established between the patient and his spoke doctor and the neurologist
• After completing a stroke assessment, which will include a CT scan, the spoke hospital's neurologists/neurosurgeon and ER physician will work in collaboration with the Gates Circle stroke vascular surgeons to determine a treatment plan including whether the patient needs stroke intervention.
• Treatment, including the administration -- if appropriate -- of clot-busting tissue plasminogen activator (or tPA), is carried out by the spoke doctor. 

"This is a wonderful joint venture that will benefit our patients in Niagara County for one of the most disabling of diseases," said Dr. Gunseli Sarpel, a Memorial Medical Center neurologist.

In addition to Millard Fillmore Hospital, the other medical trauma centers that will serve as hubs include Bassett Hospital in Otsego County, Albany Medical Center, State University of New York (SUNY) Upstate Medical Center in Syracuse and Strong Memorial Hospital in Rochester.  The additional hubs are expected to begin participation in the program by the end of 2006.

Other "spoke" hospitals scheduled to link to the stroke "hub" at Millard Fillmore Gates include Cuba Memorial Hospital, Jones Memorial Hospital (Wellsville), Olean General Hospital, Tri-County Memorial Hospital (Gowanda), Brooks Memorial Hospital (Dunkirk),  Lake Shore Health Care Center (Irving), Westfield Memorial Hospital, Inter-Community Memorial Hospital (Newfane), Medina Memorial Hospital and Wyoming County Memorial Hospital (Warsaw).

"Commissioner Novello's initiative is the most comprehensive implementation of a telestroke solution in the United States," said Sandeep J. Agate, chief executive officer of REACHMDConsult, Inc., the firm that developed the telestroke technology being utilized by Kaleida and Niagara Falls Memorial.  "Essentially, stroke care will be available in virtually every corner of New York after REACH is completely implemented in the state."