About this Journal Submit a Manuscript Table of Contents
International Journal of Telemedicine and Applications
Volume 2010 (2010), Article ID 507071, 5 pages
http://dx.doi.org/10.1155/2010/507071
Research Article

Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

Division of Cerebrovascular Diseases and Division of Critical Care Neurology, Department of Neurology, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA

Received 9 November 2009; Revised 20 April 2010; Accepted 22 June 2010

Academic Editor: Athanasios Demiris

Copyright © 2010 Bart M. Demaerschalk et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 5 3 . 2 ± 9 . 0 minutes, which included the vascular neurologist supervisory evaluation time of 1 2 . 0 ± 9 . 6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.