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Telestroke: An In-Hospital-Stroke-Care Solution

October 25, 2023

The rapid response required during a stroke care situation is not limited to those who suffer from it outside of hospital walls. Inpatient strokes are as critical as those that happen out of hospital. 

Surprisingly, various studies have shed light on the fact that the treatment and evaluation of in-hospital stroke patients often face delays, leading to extended hospitalization and increased disability.

Although protocols exist for treating strokes coming through emergency departments, the same urgency isn’t always present for in-hospital cases.

Research emphasizes the transformative potential of introducing an inpatient code stroke algorithm alongside a targeted educational campaign.

By focusing on bridging the gap between knowledge and timely action, this intervention was successful in improving response times from recognizing symptoms (LSN) to initial assessment and brain imaging.

The findings are particularly significant considering that these response times are directly linked to evidence-supported treatment options for acute stroke care, such as thrombolysis or endovascular thrombectomy.

Such telestroke advancements hold the key to changing the trajectory of inpatient stroke care.

By leveraging telestroke technology, healthcare institutions can offer equitable treatment, whether the stroke occurs inside or outside their walls.

The value of telestroke, in this case, is undeniable, ensuring that every stroke—irrespective of its location—is treated as the emergency it is.

Why are in-hospital stroke patients at a bigger risk than stroke patients that originate outside of the hospital?

In-hospital strokes, also known as “inpatient” or “hospital-acquired” strokes, can be particularly challenging for several reasons, making these patients at a bigger risk than those whose strokes originate outside of the hospital.

  • Delayed Recognition and Treatment: One of the most significant challenges with in-hospital strokes is the delay in recognizing and treating them. Stroke symptoms can be mistakenly attributed to post-surgical effects, sedation, or other medical conditions. This delay can limit the effectiveness of interventions like thrombolysis, which has a narrow treatment window. According to a study in the Journal of the American Heart Association, patients with in-hospital strokes had longer times to neuroimaging and were less likely to receive thrombolysis compared to those who had strokes outside the hospital. Source: Journal of the American Heart Association
  • Lack of Established Protocols: While many hospitals have robust stroke protocols for patients arriving in the emergency department, these protocols may not be as established or efficiently implemented for inpatients, leading to treatment delays. Source: Neurology Clinical Practice*.
  • Multiple Co-morbidities: Patients already in the hospital might be dealing with multiple health issues. When stroke symptoms occur, they might be attributed to other medical conditions or treatments rather than being identified as a new onset stroke. Source: Stroke*.
  • Logistical Challenges: Inpatients might be located in wards distant from imaging facilities or might be immobilized due to their primary illness or surgery, leading to delays in getting appropriate scans and tests done quickly. Source: Neurohospitalist*.
  • Less Frequent Monitoring: In-hospital patients, especially those not in intensive care units, might not be monitored as frequently as someone who arrives at an emergency department with stroke symptoms, leading to potential delays in recognizing the onset of a stroke. Source: Sage Journals*

Addressing the unique challenges associated with in-hospital strokes requires increased awareness, staff education, and dedicated protocols to ensure that these patients receive timely and appropriate care.

How can telestroke programs help with in-patient stroke situations?

Telestroke programs can be transformative in addressing the challenges associated with in-hospital strokes.

With immediate access to neurologists specialized in stroke care, even hospitals without on-site neurology expertise can benefit from expert consultations in real-time.

When a patient shows potential symptoms of a stroke, telestroke systems allow for rapid assessment, reducing the chances of misdiagnosing the symptoms as related to another condition or post-surgical effect.

This is particularly crucial since the swift recognition of stroke symptoms can dramatically influence treatment options and outcomes.

Furthermore, telestroke platforms streamline the decision-making process regarding treatments like thrombolysis.

Through remote evaluation using telemedicine technology, specialists can quickly determine the appropriateness of interventions and guide in-hospital teams on best practices and protocols.

This direct line to experts, coupled with the ability to share and review diagnostic images in real-time, helps bypass logistical challenges and minimizes delays, ensuring that in-hospital stroke patients receive care on par with those admitted through emergency departments.

In essence, telestroke programs bridge gaps in care and ensure that in-hospital patients receive timely and evidence-based stroke treatments.

Meet Marquis, A Telestroke Success Story

Marquis, an 81-year-old admitted with pneumonia and new-onset atrial fibrillation, suffered left sided paralysis and became speechless while eagerly awaiting discharge home.

Hospital staff promptly connected him with a teleneurologist and administered IV tenecteplase within 46 minutes.

Marquis was transferred and his partially-dissolved clot was retrieved within just 1 hour of arrival.

On the bright side, Marquis’ homecoming was delayed by only 2 days— he left the hospital feeling better than on admission, counting his blessings each day that followed.

Key Takeaways from Marquis’ Story:

Contrary to common logic, stroke treatment and outcomes while hospitalized are less favorable compared to patients outside the hospital. Thankfully for Marquis, well-structured inpatient stroke response and round-the-clock telestroke expertise mitigate inherent disadvantages that admitted patients face.

Early tenecteplase treatment increases the likelihood of stroke recovery, with a 20% clot dissolution rate pre-thrombectomy, triple the odds when combined with thrombectomy, and double the odds of functional independence after three months.

Optimizing Telestroke: Analyzing Code Stroke Response Times in Primary Stroke Centers – ED vs. Inpatient Settings

In this retrospective study conducted at a Primary Stroke Center, co-authored by Sevaro’s own by Chauncey Evers, the researchers aimed to assess and compare code stroke response times in the Emergency Department (ED) and inpatient settings. Timely stroke care is crucial for positive patient outcomes, and this study sought to provide data for a quality improvement project in the same hospital. The primary objective was to identify areas for improving code stroke response times without compromising the quality of care.

The study analyzed data from 2020, focusing on code stroke care cases that underwent a computed tomography (CT) scan. For cases receiving tissue plasminogen activator (tPA), the researchers examined various time intervals, including code-to-CT scan start, code-to-tPA, CT scan start to tPA, and CT scan completion to tPA. Cases not receiving tPA were also analyzed for response times. The ED’s code stroke response times were compared to those in the inpatient setting.

The results indicated significant differences in response times. In cases receiving tPA, the code-to-CT start time was significantly shorter in the ED compared to the inpatient setting. Similar differences were observed for cases not receiving tPA, including code-to-CT start and code-to-CT read times. The study highlighted a need to improve code-to-CT times in the inpatient setting, as the ED demonstrated more efficient response times.

The findings suggest that addressing the delays in transporting inpatients to the CT scanner after a code stroke activation is essential for improving stroke care quality. The study emphasized the importance of streamlining code stroke responses, implementing standardized protocols, and enhancing interdisciplinary coordination to achieve better outcomes for stroke patients.

Despite some limitations, including a small sample size and the impact of the COVID-19 pandemic, the study’s results underscore the significance of optimizing code stroke response times in both ED and inpatient settings. The proposed changes aim to prioritize early CT scanning, reduce delays, and ultimately save lives while preserving brain function.

Real Stories, Real Impact: The Power of Telestroke – Telestroke Success Stories

A real picture of a Sevaro telestroke neurologist on camera with a team of in-house physicians

Telestroke success stories aren’t just testimonials—they’re powerful reminders of the significant difference that our teleneurologists make every single day.

By highlighting and celebrating these successes every #telestroketuesday on our social media channels, Sevaro aims to offer neurologists a heartening glimpse into the invaluable impact of their tireless efforts.

These stories stand as beacons of hope, showcasing moments where telestroke interventions have not only treated but transformed lives. As we spotlight these triumphs, we hope to continually inspire our community of neurologists, reminding them that their dedication echoes in the countless lives they touch and change.

Embrace the world of telestroke, and let these narratives reaffirm the profound importance of the work you do.

Alan’s Telestroke Success Story

At 71, Alan, a lifelong musician, faced his second stroke in 1 month; this time with severe left-side weakness, unable to see, and unaware of his surroundings. Alan was rushed to the ER by medics for a telestroke evaluation.

As a result of his initial stroke, he couldn’t receive TNK for treatment due to the risk of bleeding. Fortunately, Alan underwent an emergency mechanical thrombectomy to remove a clot from his right middle cerebral artery.

Within two days, Alan regained function on his left side and was humming a tune with his granddaughter (his favorite backup singer) in perfect harmony.

Not surprisingly, Alan was back on stage with his band the following Saturday evening, strumming his guitar without skipping a beat. His journey is a testament to human resilience and the remarkable strides in medical technology, a reminder that the symphony of life persists even in the face of adversity.

Initial NIHSS: 20, Discharge NIHSS: 1, TICI: 3

Walter’s Telestroke Success Story

Watching television one evening with his wife Sarah, 76-year-old Walter experienced a terrifying ordeal. His words were a jumbled mess and his left hand struggled with the remote. Panic set in as Walter’s heart raced uncontrollably in atrial flutter and left side went limp.

At the local ED, a Telestroke neurologist spotted an L-shaped clot (red arrow) denying blood flow to the right half of Walter’s brain. Within “the Golden Hour” of experiencing symptoms, Walter received TNK, followed by an endovascular thrombectomy a little more than 1 hour after arriving. Time is brain.

Walter’s remarkable turnaround was made possible thanks to the rapid response of Sarah, EMTs, the Telestroke neurologist and the stroke team. Walter emerged from this ordeal with only slight left-hand clumsiness—a small price for the gift of a second chance at life with his wife of 51 years.

Initial NIHSS: 16, Discharge NIHSS: 1, DTN: 18, TICI: 3

Robert’s Telestroke Success Story

DID YOU KNOW?: COVID-19 patients with strokes are less likely to make it home after hospitalization.

In June 2023, Robert, a 55-year-old construction worker, fell ill with COVID-19 after an outbreak at work. He suffered a terrible bout of hiccups and could not even swallow a drink of water. Suddenly, he had difficulty breathing, swayed to the right and passed out in front of his children. He was rushed to a nearby emergency facility.

Thanks to telemedicine, swift collaboration with a vascular neurologist identified a brainstem stroke, further complicated by blood clots to the lungs due to COVID. After receiving the blood clot buster tenecteplase (TNK), Robert miraculously rebounded within a matter of hours on a ventilator.

Despite his initial dire condition, he emerged from the ICU a few days later, a changed man — heading back to his construction site and his family with a newfound resolution to adapt his lifestyle for healthier horizons. Robert beat the odds and made it home.

Initial NIHSS: 20, Discharge NIHSS: 0, DTN: 20

Anthony’s Telestroke Success Story

Beating Cancer and Stroke

Just days after finishing four challenging months of chemo and notching his first win against lung cancer, 71-year-old Anthony unexpectedly faced his greatest challenge yet. Emerging from the shower one day, his right leg went numb, sending him crashing to the ground. Anthony tried to call out, but his voice betrayed him: a textbook symptom of aphasia.

Fortunately, his wife heard the thud and called 911. At the comprehensive stroke center, a vascular neurologist emergently evaluated Anthony via telestroke, reviewed his medical records and counseled his wife on camera in real-time. A blood clot from Anthony’s heart was obstructing the critical T-junction formed by his left internal carotid, middle, and anterior cerebral arteries–a situation that would lead to one of the most debilitating strokes without swift action.

Within 1 hour of the vascular neurologist’s call, the neurointerventional team assembled and restored full blood flow (TICI 3) by suctioning out the clot. Anthony was immediately back to his baseline state of function hours after waking up from the procedure.

Initial NIHSS: 23, Discharge NIHSS: 0, Door To Device: 84 min, TICI: 3

Madeline’s Telestroke Success Story

77-year-old Madeline was enjoying a vacation with some old friends that were visiting from overseas. One morning, Madeline did not show up for brunch. Her friends checked on her at her hotel and found Madeline completely paralyzed on the right side, unable to utter a sound.

Acting swiftly, her friends dialed 911, getting her immediate attention from a specialized stroke team. Within 20 minutes, Madeline was evaluated remotely by a vascular neurologist and received the clot-busting drug, TNK.

Additional CT scans pinpointed the issue: a near-total blockage in her left internal carotid artery (yellow arrow). The teleneurologist immediately contacted the interventional neurosurgeon on call. A stent was placed, redirecting vital blood flow up to the brain. In just 3 days (!!), Madeline was fully recovered, allowing her to enjoy the last few days of vacation with her friends.

Initial NIHSS: 24, Discharge NIHSS: 0, DTN: 20, Length Of Stay: 4 Days

Nancy’s Telestroke Success Story

Nancy, a 73 year old retiree, was enjoying her traditional Saturday morning bowl of oatmeal and coffee with her husband while waiting for a visit from their grandchildren. Suddenly, Nancy’s face started to draw and she started to lean off the right side of her chair. A tranquil family moment turned to sheer panic.

Not knowing what to do, her husband’s quick thinking led him to call their daughter – a local gynecologist, who urged an immediate 911 call.

Rushed to the ER, scans showed a dangerously narrowed carotid artery and TWO blood clots threatening her brain. Nancy underwent a successful thrombectomy and stent placement, which eventually led to the diagnosis of the silent time-bomb that had caused those blood clots: atrial fibrillation.

Thanks to the assistance and quick intervention of teleneurology, Nancy is back to the family traditions that she cherishes so much.

Initial NIHSS: 4, Discharge NIHSS: 0 TICI: 2b
 

Learn more about how Sevaro makes these telestroke success stories possible.

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    Robot-Assisted Transcranial Doppler Versus Transthoracic Echocardiography for Right to Left Shunt Detection

    October 13, 2023

    A prospective clinical trial compared two methods, robot-assisted transcranial Doppler (raTCD) and transthoracic echocardiography (TTE), to see which one is better at diagnosing right-to-left shunt (RLS), a risk factor for stroke especially in young patients.

    The study found that raTCD was three times more likely to diagnose RLS than TTE, with a higher sensitivity, especially for large shunts. RaTCD was deemed safe and could be performed by health professionals without extensive TCD training, potentially making it a superior screening method for RLS compared to TTE.

    As a result, raTCD should become part of the cryptogenic stroke workup.

    Read The Full Study Here

    What is a cryptogenic stroke?

    A “cryptogenic stroke” is a term used to describe a stroke that doesn’t have a clear cause after initial testing and evaluation. In other words, doctors have tried to figure out why the stroke happened but haven’t identified a definite reason.

    The “workup” for a cryptogenic stroke involves a series of tests and evaluations to try to find the cause. The goal is to identify any underlying conditions or risks so that targeted treatments can be applied to prevent another stroke in the future.

    The workup can include a range of tests such as:

    • Imaging: This might include MRI or CT scans of the brain to get detailed pictures of the areas affected by the stroke.
    • Heart Monitoring: Devices like Holter monitors or event recorders might be used to monitor heart rhythms over a period of time. This can help identify irregular heart rhythms, like atrial fibrillation, which can lead to strokes.
    • Blood Tests: These can help identify clotting disorders or other blood conditions that might increase stroke risk.
    • Ultrasounds: These might be done of the heart (echocardiography) or of the blood vessels in the neck (carotid ultrasound) to look for potential sources of clots that could cause a stroke.
    • Cerebral Angiography: This is a more invasive test where a dye is injected into the blood vessels of the brain to look for any abnormalities.
    • Other Tests: Depending on the patient’s situation, other tests might be conducted to look for less common causes.

    Once all these tests are done, if a clear cause is still not found, the stroke remains classified as “cryptogenic.” However, even if a specific cause isn’t identified, treatment to reduce the risk of another stroke, such as blood thinners or blood pressure medications, may still be recommended.

    What is a robot-assisted transcranial Doppler (raTCD)

    Transcranial Doppler (TCD) is a non-invasive ultrasound method used to measure the flow velocity of cerebral blood vessels. It helps in assessing various neurological conditions, like detecting emboli, vasospasm after a subarachnoid hemorrhage, and assessing blood flow in conditions like sickle cell disease.

    Robotically assisted TCD system provides an alternative to manual TCD for assessment, expanding the availability of TCD to settings in which specialized clinicians are not available.

    What is right-to-left shunt (RLS)?

    A right-to-left shunt (RLS) refers to a condition where blood moves directly from the right side to the left side of the heart, bypassing the lungs. This can result in deoxygenated blood (blood that hasn’t been enriched with oxygen from the lungs) being pumped out to the body, which can lead to a variety of health issues.

    There are a few different ways that a right-to-left shunt can happen:

    • Congenital Heart Defects: These are structural problems with the heart that are present at birth. Examples include:
      • Atrial Septal Defect (ASD): A hole in the wall between the two upper chambers of the heart.
      • Ventricular Septal Defect (VSD): A hole in the wall between the two lower chambers of the heart.
      • Patent Foramen Ovale (PFO): A hole between the two upper chambers of the heart that fails to close after birth.
      • Eisenmenger Syndrome: A condition where a long-standing left-to-right cardiac shunt causes pulmonary hypertension and eventually reverses to a right-to-left shunt.
    • Pulmonary Hypertension: Increased pressure in the pulmonary arteries can cause blood to flow from the right to the left side of the heart.
    • Pulmonary AVMs (Arteriovenous Malformations): Abnormal connections between arteries and veins in the lungs can also cause a right-to-left shunt.

    When there’s a right-to-left shunt, it increases the risk of certain complications. For example, clots or particles in the bloodstream that would normally be filtered out by the lungs can bypass this filtering system and travel directly to the brain or other organs. This can increase the risk of stroke or systemic embolism.

    It’s important to diagnose and treat right-to-left shunts, as management strategies can reduce the risk of associated complications.

    Why would a neurologist find it important to study right-to-left shunt (RLS)?

    A neurologist would find it important to study right-to-left shunts (RLS) for several reasons, primarily because of the neurological implications and potential complications associated with such shunts:

    • Risk of Stroke: One of the most significant concerns with a right-to-left shunt is the potential for paradoxical embolism. Normally, any small clots or debris in the venous system would be filtered out by the lungs. However, with a right-to-left shunt, these can bypass the lungs, entering the arterial system, and potentially travel to the brain, causing a stroke.
    • Migraine Connection: Some studies have suggested a link between patent foramen ovale (PFO), a type of right-to-left shunt, and migraine headaches, especially migraines with aura. The exact mechanism is not entirely clear, but closing the PFO has been shown in some studies to reduce the frequency and severity of migraines in certain patients.
    • Transient Ischemic Attacks (TIAs): Similar to the risk of stroke, smaller emboli that don’t necessarily cause permanent damage can lead to transient ischemic attacks, which are brief episodes of neurological dysfunction.
    • Cryptogenic Stroke: In cases where a stroke has occurred and the cause is unclear (termed “cryptogenic”), the presence of a right-to-left shunt, like a PFO, might be considered as a potential source. A neurologist might then be involved in the evaluation and management of such cases.
    • Detection during Neurological Imaging: During procedures like transcranial Doppler (TCD) with a bubble study, right-to-left shunts can be detected. A neurologist may be involved in ordering or interpreting such tests, especially if there’s a suspicion of an RLS based on a patient’s clinical presentation.
    • Overall Patient Management: Recognizing the presence of a right-to-left shunt can influence a neurologist’s recommendations on treatments, preventive strategies, and potential referrals for intervention.

    Given these potential neurological consequences and the importance of early detection and appropriate management, studying right-to-left shunts becomes crucial for neurologists.

    Study Contributions

    In recognition of this monumental work, we want to extend our heartfelt congratulations and appreciation to our very own Dr. Ruchir Shah, Director of Clinical Service Lines & Implementations.

    Enrolling the highest number of patients in the USA for the study is no small feat, and it underscores Dr. Shah’s passion and dedication to advancing medical research. His contributions to this study have undoubtedly brought us closer to enhancing the diagnostic methods for RLS, a critical step forward in stroke prevention.

    Introducing our new CEO and CMO

    October 3, 2023

    Position title

    Raj Narula, MD , CEO Sevaro

    SEVARO HEALTH ANNOUNCES NEW CEO, CMO

    NEW YORK, NY (August 29, 2023) Sevaro, a physician-led teleneurology and telehealth platform company leveraging data to improve efficiency and patient outcomes, is pleased to announce the appointment of Dr. Kunal Agrawal as its new Chief Medical Officer, and Dr. Rajiv Narula as the new CEO.

    Who is Dr. Rajiv Narula, CEO?

    Dr. Narula brings a wealth of experience and expertise. Prior to assuming his new role, he served as Sevaro’s Chief Medical Officer, where he successfully led the company through a period of rapid growth and expansion.

    His passion for healthcare and technology has established him as one of today’s most impactful leaders within the neuroscience industry. As the former Director of Teleneuroscience at Cooper University Hospital, he has a proven track-record of making neurological care accessible and affordable to those who need it most.

    His vision is to combine data, logistics, compassion and best in class neurological care to drastically improve patient outcomes.

    Who is Dr. Kunal Agrawal, CMO?

    Taking on the role of Chief Medical Officer, Dr. Kunal Agrawal will assume leadership of Sevaro’s clinical team while providing strategic direction across all clinical service lines, rooted in the principles of a patient-first approach.

    His extensive experience includes a professorship in Neurology and prior responsibility as the vascular neurology fellowship director at the University of California, San Diego.

    With over 12 years of expertise in Teleneurology, he possesses an in-depth comprehension of the challenges and prospects inherent in the neuroscience industry.

    Dr. Agrawal has garnered both regional and national acclaim for his unmatched clinical care and pioneering research in stroke and stroke rehabilitation, boasting publications in prestigious journals like Neurology, Stroke, and JAMA Neurology.

    “It is an honor for Sevaro to have such an accomplished, thoughtful vascular neurologist lead Sevaro’s team as Chief Medical Officer,” said Dr. Narula. “Dr. Agrawal’s experience at University of California, San Diego will help elevate Sevaro’s unwavering commitment to provide the highest quality of neurological care. His servitude leadership, clinical expertise, and vision for the future of how neurological care is delivered through the use of telemedicine and artificial intelligence will help improve the lives of hundreds of thousands of patients. The Sevaro team could not be more thrilled that Dr. Agrawal chose Sevaro as his next home, and we look forward to reshaping the future of healthcare with his leadership.”

    Sevaro is committed to providing accessible, high-quality healthcare solutions to patients around the world.

    With the appointments of Dr. Narula and Dr. Agrawal, Sevaro will continue to be at the forefront of digital health innovation, and help to shape the future of the healthcare experience, through a patient’s medical journey.

    About Sevaro Health

    Sevaro revolutionized and personalized teleneurology with one goal: To enable partner hospitals and systems to enhance stroke care and save lives.

    Sevaro OneCall™ technology connects hospital staff directly to an on-call vascular neurologist in 45 seconds, eliminating call centers, and saving time when time is everything.

    Our singular, relentless focus on teleneurology and doing it better (and faster) than anyone has ever dreamed has resulted in the industry’s fastest response, imaging review, and door-to-needle times, and the very best patient outcomes.

    Weathering Disasters with Teleneurology: A Beacon for Continuity in Neurological Care

    August 30, 2023

    Ensuring Continuity of Care: Telemedicine’s Vital Role During Natural Disasters

    In the face of natural disasters like tornadoes, hurricanes, and flooding, hospitals often bear the brunt of disruptions, making it challenging to deliver essential medical services to those in need.

    However, innovative solutions like teleneurology have emerged as crucial tools, bridging the gap between patients and healthcare providers during the most trying times. One area where telemedicine shines is its ability to provide patient care at partner hospitals during these natural disasters, thanks to robust downtime procedures.

    Riding Out the Storm with Resilience

    Teleneurology companies like Sevaro are at the forefront of the healthcare technology evolution, offering remote neurology consultations and expertise through their own revolutionary digital platform.

    When disasters strike and traditional healthcare infrastructure faces significant disruptions, Sevaro can play a pivotal role in ensuring that patient care doesn’t come to a standstill. This is where downtime procedures come into play.

    1 . Redundant Systems and Data Backup

    Leading telemedicine companies like Sevaro have redundant systems in place, distributing their services across multiple servers and data centers.

    This ensures that even if one location is impacted by a disaster, the system can seamlessly switch to another location with minimal interruption. Additionally, frequent data backups safeguard patient information, medical history, and ongoing treatments, allowing healthcare providers to access critical data from any location.

    2. Remote Access and Support

    During natural disasters, roads may be inaccessible, and traditional hospital operations might be compromised due to clinicians being unable to reach the facility.

    Telemedicine allows healthcare providers to offer remote support to partner hospitals, guiding on-site medical staff through crucial decisions, diagnoses, and treatment plans. This real-time assistance can be a lifeline for patients in need, especially when specialist expertise is required.

    3. Collaborative Networks

    Telemedicine providers like Sevaro have established networks of seasoned neurologists working remotely from across the country, ensuring that even during disasters, there’s a vast pool of expertise to tap into.

    Sevaro innovated OneCall™ to save lives with an unprecedented 45 second response time. OneCall™ eliminates call centers from the equation, enabling hospitals to reach a Sevaro neurologist directly and immediately, even in the worst of weather conditions.

    Through virtual stroke consultations, these experts can share their knowledge and recommendations, aiding partner hospitals in providing quality care to both acute and general neurology patients.

    4. Training and Preparedness

    To ensure effective utilization of telemedicine resources during disasters, Sevaro provides training to partner hospitals and their staff.

    Regular drills and simulations help medical professionals become familiar with the platform, making it easier for them to navigate and provide care when facing real-life crises.

    Conclusion

    Natural disasters can throw hospitals into disarray, but telemedicine’s downtime procedures have proven to be a game-changer. By leveraging redundant systems, remote access, collaborative networks, and preparedness training, companies like Sevaro enable partner hospitals to continue delivering patient care during the most challenging times.

    This synergy of innovation and resilience demonstrates how innovation, technology,, and proactive planning can make a difference in safeguarding human lives, even amidst nature’s fury.

    Simplifying Teleneurology Implementation with Sevaro: A Comprehensive and Collaborative Approach

    August 25, 2023

    Telestroke consult with teleneurologist

    Teleneurology Implementation

    Introduction:

    In the era of rapidly advancing technology, teleneurology implementation presents an exciting frontier in the medical realm. However, such implementations often require intense labor and can pose significant disruptions, especially in intricate environments like hospitals. Understanding this challenge, Sevaro provides a streamlined approach that focuses on partnership, customization, and efficient communication, all essential elements in the complex process of integrating teleneurology into hospitals.

    Sevaro’s Detailed Teleneurology Implementation Process:

    1. Emphasis on Clear and Open Communication:

    Sevaro’s approach to teleneurology implementation prioritizes transparency and collaboration. Recognizing that hospital environments involve multiple stakeholders with varied interests, they initiate active dialogue with everyone – from top-tier administrators to physicians, and even the technical wizards in the IT department.

    What sets Sevaro apart?

    • An unwavering commitment to listening. Sevaro’s team takes the time to fully comprehend a hospital’s unique requirements and potential reservations regarding teleneurology.
    • Swift addressal of concerns, ensuring no bottlenecks or uncertainties stall the process.
    • Periodic updates ensuring every stakeholder is abreast of the progress, fortifying confidence and synchrony during the teleneurology implementation for hospitals.

    Through such holistic communication, Sevaro cultivates an atmosphere of trust, paving the way for a teleneurology setup that complements the hospital’s existing systems seamlessly.

    2. Crafting Well-Defined Timelines:

    Time is of the essence, especially in medical environments. Sevaro appreciates this and accentuates the importance of meticulous planning. Crafting realistic timelines isn’t just about deadlines; it involves understanding the hospital’s internal challenges, unique requirements, and pacing the teleneurology implementation process accordingly.

    Collaborating with the hospital team, Sevaro:

    • Sets attainable milestones.
    • Clearly demarcates deliverables.
    • Offers a lucid roadmap, thus empowering hospitals to allocate their resources judiciously, maintain momentum, and vigilantly monitor each step.

    3. Provision of Tailored Solutions and Demonstrated Flexibility:

    No two hospitals are identical, neither in structure nor in operation. Sevaro fully embraces this concept. As teleneurology implementation strategists, their approach revolves around deep assessments and analyses tailored to the unique fabric of each hospital. This includes exhaustive consultations with hospital teams to comprehend existing workflows, clinical protocols, and anticipated challenges.
    By eschewing a one-size-fits-all model, Sevaro ensures the process is efficient, relevant, and minimally disruptive. The end result? A seamless transition into the world of teleneurology, uniquely tailored for each institution.

    4. Building Robust Partnerships:

    Rather than viewing their role as mere service providers, Sevaro positions itself as a committed partner in the journey of teleneurology implementation. Their philosophy underscores the importance of mutual objectives, close collaboration, and a shared vision.

    Investing significant time and resources, Sevaro seeks to grasp the intricacies of a hospital’s operations, their patient profiles, and even their future ambitions. This partnership-first approach doesn’t just ensure a smooth implementation; it lays the groundwork for sustained support, future training, and the potential for iterative advancements.

    5. Comprehensive Training and Support:

    For Sevaro, teleneurology implementation doesn’t culminate with system integration. They delve deeper, ensuring that hospital staff are proficient in navigating and leveraging the new teleneurology technology. This includes:

    • Curated training sessions designed for diverse user needs.
    • Comprehensive documentation that serves as a ready reference.
    • Accessible resources that empower healthcare professionals to optimize their teleneurology tools.

    Post-implementation, Sevaro’s dedicated support teams remain a beacon, promptly addressing queries and ensuring the technology continues to be a boon and not a bottleneck.

    Why Partner with Sevaro

    Sevaro is a physician-led company that continues to improve telestroke responses and patient outcomes with evidence-based care. The Montana Hospital Association (MHA) recently named Sevaro as their preferred stroke care and management vendor.

    Our team remains highly dedicated to supporting hospitals with the specialization in responding to time-sensitive stroke emergencies.

    Research shows that Sevaro reduces

    • Acute neuro-transfer rates by as much as 90%
    • DTN (door-to-needle) time by as much as 50%
    • In-patient LoS (length of stay) by up to 25%.

    We will differentiate and expand your hospital’s care services. By partnering with Sevaro, your healthcare organization can look forward to optimized 24/7 telestroke and inpatient teleneurology assistance that delivers the best patient outcomes.

    Conclusion:

    Sevaro makes it simple! 

    In the labyrinthine process of teleneurology implementation for hospitals, Sevaro emerges as the guiding light. With their meticulous methods, collaborative approach, and unwavering support, Sevaro truly simplifies the complex, ensuring hospitals are well-equipped to venture confidently into the digital neurology realm.

    More About Telestroke – How It Works And What Conditions It Can Help With

    August 21, 2023

    A stroke survivor hugging his grandkids

    What Is Telestroke?

    Telehealth offers remote medical services, bringing enhanced healthcare to remote areas and immediate access to emergency care when the time to treatment is critical.

    Telestroke refers to a telehealth process that connects physicians specializing in neurological disorders and stroke with hospitals and medical facilities in another location. These specialized physicians work with a patient’s emergency medicine doctors to diagnose stroke and recommend treatment for more successful outcomes.

    Sevaro delivers top-tier telestroke solutions for U.S. hospitals and healthcare systems, empowering them with immediate access to either their in-house  or additional stroke experts through our telestroke technology

    How Does Stroke Telemedicine Work?

    Stroke telemedicine connects an originating site where the patient is located to a distant site such as an urban medical center with stroke-ready training and protocols. A team of telestroke-trained caregivers work together at the distant site, relaying assessment and treatment to the medical personnel at the originating site.

    Through digital video communication, internet-accessible electronic healthcare records, tablets and other mobile technologies, neurocritical care physicians can observe and communicate with patients in real-time. With the help of physicians and medical staff at the originating site, a diagnosis can be made and treatment administered immediately.

    Types of Stroke

    Knowing what type of stroke a patient is experiencing helps determine treatment and leads to better outcomes and recovery. The main types of stroke are ischemic, hemorrhagic and transient ischemic attack (TIA).

    • Ischemic strokes account for 87% of strokes and are caused when blood flow to the brain is blocked. These blockages are often caused by blood clots.
    • Hemorrhagic strokes happen when an artery in the brain leaks blood or bursts, causing the pooling blood to put pressure on brain cells, damaging them. The typical causes of hemorrhagic strokes include high blood pressure and bulges in an artery that stretch and burst, called an aneurysm.
    • A transient ischemic attack is known as a mini-stroke. TIAs only block blood flow to the brain for a short time — no more than 5 minutes or so. However, a TIA is a stark warning of a future ischemic or hemorrhagic stroke and is still considered a medical emergency.

    What Emergent Conditions can Telestroke Services help With?

    • Acute Spinal Cord Injury
    • Alzheimer’s Disease
    • Amyotrophic Lateral Sclerosis (ALS)
    • Ataxia
    • Bell’s Palsy
    • Brain Tumors
    • Cerebral Aneurysm
    • Epilepsy and Seizures
    • Guillain-Barré Syndrome
    • Headache
    • Head Injury
    • Hydrocephalus
    • Lumbar Disk Disease (Herniated Disk)
    • Meningitis
    • Multiple Sclerosis
    • Muscular Dystrophy
    • Neurocutaneous Syndromes
    • Parkinson’s Disease
    • Stroke (Brain Attack)
    • Cluster Headaches
    • Tension Headaches
    • Migraine Headaches
    • Encephalitis
    • Septicemia
    • Myasthenia Gravis

    Speak With Us Today

    Learn more about how Sevaro’s telestroke technology platform and team of virtual neurologists can support your neurology program. Schedule your initial consult today!

    Learn More About Working With Sevaro!

    Connect With Our Recruiter To Learn More

    Why Should Neurologists Collaborate with a Neurologist-Led Telemedicine Company?

    July 21, 2023

    Revolutionizing Neurological Care with Teleneurology and Telestroke: The Sevaro Advantage

    Introduction

    Telemedicine has ushered in remarkable advancements in healthcare in recent years, enabling medical professionals to deliver remote care to patients regardless of time or location. Neurology, among various medical specialties, has experienced significant growth in this field. In this blog, we explore the benefits of neurologists collaborating with a teleneurology company like Sevaro, founded and led by neurologists, and how this partnership can revolutionize neurological care.

    Your Go-To Telemedicine Company for Teleneurology

    Sevaro, a neurologist-led telemedicine company, brings together a team of experts with an in-depth understanding of neurological conditions and treatments. This specialized knowledge ensures the most accurate diagnoses, effective treatment plans, and optimal patient outcomes. With the ability to collaborate and seek guidance from peers, teleneurologists can deliver the highest standard of care. Sevaro’s approach fosters proficiency and reduces the case load, setting it apart from other teleneurology companies.

    Telestroke Services Expand Reach

    Teleneurology overcomes geographic barriers, enabling neurologists to extend their reach far beyond their physical location. Patients in rural or underserved areas can access specialized neurological care without traveling long distances to major metropolitan areas. Sevaro’s commitment to expanding the patient base helps address the geographic maldistribution of neurologists, making a significant impact on communities lacking adequate access to neurological expertise, including life-saving telestroke services.

    Advanced Medical Technology Tools for Enhanced Care

    Working with a neurologist-led telemedicine company ensures access to state-of-the-art medical technology specifically designed for neurological assessments. Teleneurologists are typically required to learn multiple EHRs, remember numerous passwords, fax, and use numerous imaging softwares. Sevaro’s innovative solution, Synapse 2.0, serves as a clinical navigation tool that allows neurologists to achieve better patient outcomes by allowing them to focus on the patient, not disparate telemedicine technologies. Within Synapse 2.0 is the Nirvana Notes platform, which has built-in clinical decision support tools that dramatically improve documentation efficiency, enabling neurologists to focus more one-on-one attention on their patients.

    Telestroke Services Ensure Timely Intervention and Reduced Wait Times

    Sevaro’s revolutionary OneCall system ensures neurologists can provide timely interventions in telestroke cases, recognizing that “time is brain.” Calls reach the on-call teleneurologist within 45 seconds, optimizing patient care efficiency during critical moments. Sevaro is dedicated to pushing the boundaries of teleneurology and telestroke by continuously exploring emerging medical technologies and advancements. This singular focus keeps them at the forefront of innovation, continuously reducing wait times, enhancing patient outcomes, and improving access to care in the field of neurology.

    Conclusion

    Designed by neurologists for neurologists, Sevaro prioritizes your voice in shaping the future of neurological care. With our commitment to doing the right thing for patients and each other, our neurologists have a sense of fulfillment and work-life balance that many thought was impossible. By mutually agreeing on the number of shifts worked per month, Sevaro prevents burnout and fosters a highly rewarding environment. 

    Offering neurological services nationwide through our unique telemedicine platform, Sevaro pioneers innovation in telestroke and neurological care. Embrace the transformative changes in neurology made possible by collaborating with Sevaro, where teleneurology and telestroke services redefine the boundaries of modern healthcare. Sevaro is your trusted partner for elevating the standards of neurology in the digital age.

    Teleneurologist: Part Time

    Part Time

    Job Details

    Position title

    Teleneurologist – Vascular Neurologist, Neurohospitalist, Epileptologist

    Shift Availability

    7 shift minimum including 1 weekend shift and 1 night shift.

    Comapny Description

    Sevaro is a leading tele-neurology company that combines compassion, care, and innovation to revolutionize neurological healthcare. Our name, rooted in the word “Seva” meaning compassion and care for others, reflects our unwavering commitment to providing patient-centric neurological care through our proprietary technology. 

    At Sevaro, we are dedicated to pushing the boundaries of telemedicine and neurology by continuously exploring emerging technologies and advancements. By staying at the forefront of innovation, we aim to enhance patient outcomes, improve access to care, and bring about transformative changes in the field of neurology. 

    Position Highlights

    As a Teleneurologist, you will examine stroke and neurology patients virtually using HIPAA-compliant telemedicine technologies. This exciting opportunity offers the ability to provide best-in-class patient care with an extremely competitive pay and a flexible work life balance.

    Sevaro’s innovative solution allows our providers to achieve better patient outcomes. Sevaro values physician satisfaction and work-life balance. Our dynamic team creates an exciting culture that enables physicians to grow with the company.

    You don’t work for us
    you grow with us!

    Position Requirements

    • Excellent communication skills with a focus on physician-patient interaction
    • Comfortable with using HIPAA compliant audio/video technology, EMRs and PACs
    • Board Certified or Board Eligible
    • Possess or able to obtain an unrestricted Medical License in any US State
    • Prior hospital-based, in-person Neurology and Stroke experience is preferred
    • Prior teleneurology experience is preferred

    Program Offering Includes

    • Competitive compensation package
    • Equity offering 
    • Stipend for Admin Work
    • Flexible scheduling
    • Incredibly collaborative work culture 
    • Regional Medical Director opportunities
    • Technology and Malpractice Coverage Provided
    • Cost of Licensing and Credentialing Covered by Sevaro

    Teleneurologist: Full-Time

    Full Time

    Job Details

    Position title

    Teleneurologist – Vascular Neurologist, Neurohospitalist, Epileptologist

    Shift Availability

    15 shifts includes 4 weekend shifts  (75% of shifts minimum will be placed in the day, remaining 25% may be assigned to PM as needed) 

    Comapny Description

    Sevaro is a leading teleneurology company that combines compassion, care, and innovation to revolutionize neurological healthcare. Our name, rooted in the word “Seva” meaning compassion and care for others, reflects our unwavering commitment to providing patient-centric neurological care through our proprietary technology. 

    At Sevaro, we are dedicated to pushing the boundaries of telemedicine and neurology by continuously exploring emerging technologies and advancements. By staying at the forefront of innovation, we aim to enhance patient outcomes, improve access to care, and bring about transformative changes in the field of neurology. 

    Position Highlights

    As a Teleneurologist, you will examine stroke and neurology patients virtually using HIPAA-compliant telemedicine technologies. This exciting opportunity offers the ability to provide best-in-class patient care with an extremely competitive pay and a flexible work life balance.

    Sevaro’s innovative solution, Synapse, serves as a clinical decision making tool that allows our neurologists to achieve better patient outcomes. Sevaro values physician satisfaction and work-life balance. Our dynamic team creates an exciting culture that provides a platform for physicians to grow with the company.

    You don’t work for us
    you grow with us!

    Position Requirements

    • Excellent communication skills with a focus on physician-patient interaction
    • Comfortable with using HIPAA compliant audio/video technology, EMRs and PACs
    • Board Certified or Board Eligible
    • Possess or able to obtain an unrestricted Medical License in any US State
    • Prior hospital-based, in-person Neurology and Stroke experience is preferred
    • Prior teleneurology experience is preferred

    Program Offering Includes

    • Competitive compensation package
    • Equity offering 
    • Flexible scheduling
    • Incredibly collaborative work culture 
    • Regional Medical Director opportunities

    Full Time Benefits Include:

    • Health, Vision, Dental, Life coverage
    • 401k 4% match
    • Stipend for Admin Work
    • Technology and Malpractice Coverage Provided
    • Cost of Licensing and Credentialing Covered by Sevaro

    Teleneurohospitalist Rounding – Best Practices

    March 29, 2023