VA Telestroke uses new technologies to save lives

No, it’s not science fiction: Artificial intelligence has come to VA’s National Telestroke Program.

Combined with existing telehealth capabilities, this innovation will further increase the speed at which Veterans receive care when having a stroke.

VA’s telestroke program offers services at 52 VA medical centers and employs a team of 27 physicians who specialize in vascular neurology. Since the program started in 2017, it has provided care to more than 5,000 Veterans.

According to the U.S. Centers for Disease Control and Prevention (CDC), patients who arrive at the emergency room within three hours of their first symptoms often have less disability three months after a stroke than those who received delayed care.

“When a Veteran exhibits stroke symptoms, a fast response increases the chance of a positive outcome,” said Dr. Will Musser, National Telestroke Program chief medical officer.

Local provider makes video call and recommends best course of treatment.

“For a Veteran at a VA facility showing signs of stroke, a local provider makes a video call to one of the telestroke physicians so they can get a fast, real-time assessment of the Veteran’s condition, determine whether the Veteran is indeed having a stroke, and recommend the best course of treatment,” Musser said.

These video calls enable telestroke neurologists to examine the Veteran, review medical records, and guide treatment within minutes.

As part of this assessment, the telestroke team uses VA’s Image Viewing Solution (IVS) to review diagnostic-grade clinical images of the Veteran’s brain scans, either on a web browser securely connected to the VA network or on a VA-issued iPad or iPhone.

Physician can make treatment decisions rapidly

And now VA plans to incorporate artificial intelligence, or AI, to review the brain scans for blood vessel occlusion.  The AI is a computer program that can learn to recognize patterns.

In this case the characteristic findings of a blockage in one of the large blood vessels in the head and neck.

AI can identify those Veterans with this type of large vessel blockage causing a stroke more quickly than the provider could alone.

“AI is flagging blood vessel occlusions so that by the time the images get to physician review, they’re already marked and the physician can then confirm the findings quickly and make treatment decisions rapidly,” Musser said.

Especially important for Veterans in rural areas

For telestroke neurologists, the speed at which AI enables VA to detect strokes will be especially important for Veterans in rural areas.

“Many Veterans live hours away from a medical facility that has a comprehensive stroke center where they would typically need to go to be assessed. But we’ve solved this ‘distance problem’ with technology,” Musser said. “By using iPad Pros for video calls, IVS, and AI, we can see patients regardless of where they live and evaluate them as quickly as if they lived across the street from a stroke center hospital.”

To read more telehealth-related blogs, visit https://news.va.gov/?s=telehealth.