<div><br>The following is for your consideration...</div>
<div><br> </div>
<div class="gmail_quote">---------- Forwarded message ----------<br>From: <b class="gmail_sendername">Thielst, Christina B -- NRTRC</b> <span dir="ltr"><<a href="mailto:ThielsC@nrtrc.org">ThielsC@nrtrc.org</a>></span><br>
Date: Mon, May 17, 2010 at 10:24 AM<br>Subject: Regional Telestroke Initiative: Invitation & Survey Opportunity<br>To: <br><br><br>
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<div dir="ltr" align="left"><font face="Calibri">Dear Telestroke Colleague:</font></div>
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<p class="MsoNormal"> </p>
<p class="MsoNormal">Are you involved with or interested in being involved in telestroke? If so, please take 5 minutes to answer this short survey for the <b><span style="FONT-SIZE: 12pt; COLOR: #c00000"><a href="https://fortress.wa.gov/doh/opinio/s?s=5055" target="_blank"><span style="COLOR: #c00000">Regional Telestroke Initiative</span></a> </span></b>by June 1<sup>st</sup>.</p>
<p class="MsoNormal">Background and more information can be found below:</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><b>Background & Need</b></p>
<p class="MsoNormal">The Washington State Department of Health <a href="http://www.doh.wa.gov/cfh/heart_stroke/default.htm" target="_blank">Heart Disease and Stroke Prevention Program</a>, <a href="http://www.nrtrc.org/" target="_blank">Northwest Regional Telehealth Resource Center (NRTRC</a>), and members of the Northwest Regional Stroke Network (NWRSN) have collaborated to address stroke care in the Northwest region. In recent years, members have voiced a need to address the significant rural-urban disparities seen in stroke treatment and care, suggesting a regional telestroke network as a potential solution. With a reach of over 200 members and organizations, a combined effort called the “<b>Regional Telestroke Initiative”</b> is being developed to respond to stakeholder requests for assistance in the development and support of such a regional network. Specifically, the Northwest region of the United States has a higher rate of death due to stroke compared to the national average. With some of the nation’s most rugged geography, harshest climates, large proportions of rural communities, and an increasing shortage of stroke specialists, the region is poised to take advantage of the growing broadband capabilities and expanding telehealth networks. </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">This concept is supported by recent literature, such as the <a href="http://stroke.ahajournals.org/cgi/reprint/40/7/2635" target="_blank">policy summary</a> from the American Heart Association, stating that with the growth of telestroke programs both nationally and abroad, there is a need to extend telestroke use beyond the urban “hubs” to the rural/community hospitals that lack readily available stroke care. In the January 2009 <a href="http://www.jointcommission.org/NR/rdonlyres/DFBF9FFD-AF97-4CA1-A9C8-8102C2D77AE0/0/JCP1009.pdf" target="_blank">Joint Commission statement</a>, “informed consultations” include bedside consultation OR telemedicine consultation from a privileged physician. Clearly, telestroke is emerging as a standard of care in the treatment of stroke related illness and we are contacting telestroke leaders, like you, to actively join us.</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><b>Mission</b></p>
<p class="MsoNormal">To reduce the rural-urban disparity by aligning regional resources and stakeholders and delivering stroke expertise to rural facilities across the Northwest region.</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><b>Barriers</b></p>
<p class="MsoNormal">Despite growing development of telestroke initiatives in the region and growing third party consulting models, a number of issues persistent in the telehealth industry continue to hamper integration into the healthcare delivery system. The current telestroke barriers seen across the country include: </p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Interstate Licensure<span style="COLOR: black"></span></p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Credentialing & Privileging</p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Liability & Malpractice<span style="COLOR: black"></span></p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Availability of On-Call Stroke Specialists<span style="COLOR: black"></span></p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Reimbursement for Drip & Ship Patients</p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Technology Compatibility<span style="COLOR: black"></span></p>
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<p class="MsoNormal"> </p>
<p class="MsoNormal"><b>Progress & Goals</b></p>
<p class="MsoNormal">For the past few years, the NWRSN and NRTRC have been partnering to address interstate telephone stroke consultations, clarification of liability issues around a regionally structured call network, and increasing clinical capacity. Future areas that will now also be addressed by the <b>Regional Telestroke Initiative</b> include providing educational opportunities, exploring grant opportunities, quality improvement initiatives, exploring audio/visual consultation, reimbursement, credentialing and privileging. </p>
<p class="MsoNormal"><b> </b></p>
<p class="MsoNormal"><b>Objectives & Format</b></p>
<p class="MsoNormal">Educational opportunities will be provided to build on progress made and address stakeholder needs. These educational opportunities would discuss the delivery of acute stroke treatment, successful telestroke solutions, and culminate in a discussion of potential strategies for a regional initiative. A potential subsequent face-to-face meeting in a central location (Seattle, Portland, or Spokane) would bring stakeholders together to further develop this initiative. Topics would include:</p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Shared On-Call Structure<span style="COLOR: black"></span></p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Interstate Licensure Compact</p>
<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Centralized Credentialing & Privileging <span style="COLOR: black"></span></p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0.25in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Compatible Technology Solution(s)<span style="COLOR: black"></span></p>
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<p class="MsoNormal"> </p>
<p class="MsoNormal"><b>Involvement</b></p>
<p class="MsoNormal">We would like to have your expertise as we pursue this goal. Potential stakeholders might include:</p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Physicians, NPs and PAs caring for stroke patients<span style="COLOR: black"></span></p>
<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Telehealth & Telestroke Networks </p>
<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>State Departments of Health<span style="COLOR: black"></span></p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>AHA/ASA<span style="COLOR: black"></span></p>
<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>National Stroke Association</p>
<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>State Board of Medical Examiners<span style="COLOR: black"></span></p>
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<p class="MsoNormal" style="MARGIN-LEFT: 0in; TEXT-INDENT: 0.5in"><span style="FONT-SIZE: 12pt; COLOR: black; FONT-FAMILY: Wingdings"><span>ü<span style="FONT: 7pt 'Times New Roman'"> </span></span></span>Hospital/health systems interested or engaged in telestroke<span style="COLOR: black"></span></p>
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<p class="MsoNormal"><b>Regional Impact </b></p>
<p class="MsoNormal">Recognizing the ultimate goal of improved outcomes, reduced morbidity and mortality, increased consideration for administration of tPA, and greater access for patients in rural communities, the creation of a <b>Regional Telestroke Initiative</b> has high potential to address persistent barriers to telehealth development. The region served by this <b>Regional Telestroke Initiative</b> also has considerable telehealth expertise and infrastructure which can be leveraged to accelerate such an initiative. </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Please indicate your interest in participating in this <b>Regional Telestroke Initiative</b> by contacting Chara Chamie at <a href="mailto:Chara.chamie@doh.wa.gov" target="_blank"><span>Chara.chamie@doh.wa.gov</span></a> <i>(by June 1, 2010)</i></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">We thank you in advance for considering this new partnership opportunity and look forward to your participation in this regional effort.</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Sincerely,</p>
<p class="MsoNormal"> </p>
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<p class="MsoNormal"><b>Nicholas J Okon, DO<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Stroke Neurologist & Hospitalist, Providence Stroke Center, Portland, OR<span style="COLOR: black"></span></p></td>
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<p class="MsoNormal"><b>Christina Thielst, FACHE,<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Executive Director, Northwest Regional Telehealth Resource Center, Spokane, WA<b><span style="COLOR: black"></span></b></p></td>
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<p class="MsoNormal"><b>Mike McNamara, MS<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Telestroke Specialist and Consultant, Montana Department of Public Health & Human Services, Billings, MT<span style="COLOR: black"></span></p></td>
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<p class="MsoNormal"><b>David Tirschwell, MD, MSc<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Stroke Neurologist,</p>
<p class="MsoNormal">University of Washington, Harborview Medical Center, Seattle, WA<b><span style="COLOR: black"></span></b></p></td>
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<p class="MsoNormal"><b>Denny Lordan,<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Telestroke Specialist and Consultant, Washington State, Spokane, WA</p>
<p class="MsoNormal"><b><span style="COLOR: black"> </span></b></p></td>
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<p class="MsoNormal"><b>Bill Likosky, MD</b></p>
<p class="MsoNormal">Stroke Neurologist, </p>
<p class="MsoNormal">Swedish Medical Center, Seattle WA<b><span style="FONT-SIZE: 10pt"></span></b></p></td>
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<p class="MsoNormal"><b>Chara Chamie, MPH<span style="COLOR: black"></span></b></p>
<p class="MsoNormal">Regional Telestroke Initiative Planning Coordinator, Washington State Department of Health, Olympia, WA<span style="COLOR: black"></span></p></td></tr></tbody></table>
<p class="MsoNormal"> </p></div></div></div><br><br clear="all"><br>-- <br>Catherine S. Britain<br><a href="mailto:csbritain@gmail.com">csbritain@gmail.com</a><br>541-910-7366<br>