Friday, March 9, 2018

New bill to increase access to care for stroke patients

Schwamm

Hard work pays off, and health institutions and stroke patients all over the country will soon find out how. The Furthering Access to Stroke Telemedicine (FAST) Act was recently signed into law.

The FAST Act encourages hospitals to use telemedicine in stroke care by allowing sites across the country to bill for telemedicine consultations. With a financial barrier broken down, the act will increase access to care for stroke patients, thereby diminishing long-term disability and ultimately saving more lives.

The bill takes effect in January 2019 and one key to its success was part of an advocacy campaign spearheaded by the American Heart Association (AHA), which was joined by the American Academy of Neurology (AAN).

“It’s a remarkable accomplishment,” says Lee Schwamm, MD, executive vice chair of Neurology and director of the MGH Comprehensive Stroke Center. “It’s hard work and I’m thrilled to see that this bill passed with its core principles intact and without being altered by the legislative process. It was in the right place at the right time and in the right hands when Congress came together to pass the budget resolution.”

Schwamm testified in front of the United States Senate Committee on Finance in support of the bill last year and has been consulting with the AHA and AAN for more than a decade to make telehealth in stroke care
more accessible. 

The concepts behind the FAST Act were first drafted in 2003 as part of the Stroke Treatment and Ongoing Prevention (STOP) Act, which ultimately failed to achieve passage because of its broad scope. This time around, the AHA and AAN sharpened the act’s focus.

“We were really laser-beam-focused on one condition, on one specified disease, where we had strong data on efficacy and projected financial savings,” Schwamm says. “This made the bill attractive to bipartisan sponsors and increased overall access to care.”

Sue Nelson, vice president of Federal Advocacy for the AHA, says passing this bill was a logical, common sense thing to do.

“All we’re doing is providing for appropriate medical care,” Nelson says. “Most people, when it was explained to them on The Hill, said ‘Why aren’t we already doing that?’ I’m happy we finally crossed the finish line.” 

Telestroke, explained

What it is: Telestroke is a videoconferencing service that enables stroke specialists from miles away to rapidly diagnose and determine the most appropriate treatment for a stroke patient who lives in a rural or suburban area. Hospitals must subscribe to telestroke services.

How it works: When a patient who lives in a remote or rural area experiences a stroke, that patient is transported to the nearest hospital – there is no time to transfer that patient to a specialty center. Through the telemedicine network, a stroke expert is immediately contacted for a consultation using a videoconferencing service. Prior to the consultation, the specialist can download and review brain CT scan images. During the videoconference consultation, the specialist will determine the severity of the stroke and whether the patient would benefit from a clot-busting IV drug, tissue plasminogen activator or from direct clot extraction by a catheter.

Why it’s important: When it comes to stroke, “time is brain.” With telestroke services, hospitals that lack the resources to diagnose and treat stroke patients can access high-quality specialty care remotely



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