Acute Stroke Telemedicine: Utility, Training and Evaluation Project (ASTUTE)

Stroke can strike at any time, day or night. An expert consultant assessment is needed to ensure that people are diagnosed and treated correctly. However, if the patient comes to hospital ‘out of hours’, there may not be a specialist consultant on call locally.

The TELESTROKE project can link a patient with suspected stroke at any of the major hospitals in Lancashire and Cumbria to one of a team of highly experienced stroke consultants via a live video link. The consultant can see the patient and vice versa, can discuss the problem with the staff in the A+E department, and can also see brain scan results. This means that the patient can get an expert diagnosis very quickly, without having to travel, and without wasting precious time. This can save lives and prevent stroke disability. Some parts of the country have similar systems in operation already.

This is a very new and exciting way of working, but it is vital that we get it right-for patients, families and staff. The ASTUTE project is evaluating the introduction of Telestroke.

Aims

ASTUTE aims to develop and test an internet based Standardised Telemedicine Toolkit (STT) which includes a training package for health staff, standardised assessments and a checklist to help doctors and nurses to use Telestroke.

The STT will be based on information from previous research, the views of people (staff, patients and carers) who have experienced Telestroke elsewhere, and people who will experience Telestroke as part of this study.

This is the first study of its kind within the NHS. We will test the STT to see if it helps more people to have an immediate stroke-specialist assessment. If it is successful, the training package will be used in similar NHS settings in the future.

Impact

The ASTUTE project will help to ensure that this new technology is introduced in a way that meets the needs of patients, and helps staff to deliver better care.

Telestroke will enable all patients to have access 24/7 to the expert diagnosis and treatment they need in a stroke emergency, wherever they are in Lancashire and Cumbria. ASTUTE will help us to ensure this is done safely and efficiently, and that patients and families are confident in this new way of working.

The Standardised Telemedicine Toolkit for Stroke can be accessed by going to: ASTUTE Website

Timeline

2010-present

Funders

National Institute for Health Research- Research for Patient Benefit.

Gibson J, Fitzgerald J, Gibson A, McAdam J, Lightbody L, McLoughlin A, Watkins C, Day E. Using telemedicine for acute stroke assessment. Nursing Times. 2013;109(35):14-16.

Abstracts (including abstracts presented as posters or oral presentations)

Gibson JME, Lightbody CE, French B, McLoughlin A, Fitzgerald J, Gibson AM, McAdam JJ, Day E, Davies P, Emsley H, Ford G, Price C, May C, O’Donnell M, Watkins CL. Introducing Telemedicine in Acute Stroke: patients’ and carers’ perspectives. Cerebrovascular Diseases. 2013;35(Suppl 3):669. [Presented as poster and oral presentation on poster tour at XXII European Stroke Conference, 28-31 May 2013, London, UK].

Lightbody L, Gibson J, French B, McLoughlin A, Fitzgerald J, Gibson A, McAdam J, Day E, Davies P, Emsley H, Ford GA, Price C, May C, O’Donnell M, Watkins CL. Implementing telemedicine in acute stroke: staff perspective. International Journal of Stroke. 2012;7(Suppl 2):8. [Oral presentation by McLoughlin A at 7th UK Stroke Forum Conference, 6 December 2012, Harrogate, UK].

French B, Lightbody L, McLoughlin A, Fitzgerald J, Day E, Davies P, Emsley H, Ford GA, Jenkinson D, Leathley MJ, Price C, May C, O’Donnell M, Sutton CJ, Watkins CL. Implementing telestroke: Developing a Standardised Telemedicine Toolkit. International Journal of Stroke. 2011;6(Suppl 2):14. [Presented as poster at 6th UK Stroke Forum Conference, 30 November 2011, Glasgow, UK].

French B, Lightbody CE, Clarke JR, McLoughlin AS, Day E, Davies P, Emsley H, Ford GA, Jenkinson D, Leathley MJ, Price C, May CR, O'Donnell M, Sutton CJ, Watkins CL. Telemedicine in acute stroke: synthesising evidence on implementation. Cerebrovascular Diseases. 2011;31(Suppl 2):220. [Presented as poster at XX European Stroke Conference, 24-27 May 2011, Hamburg, Germany].

Lightbody CE, McLoughlin A, Fitzgerald J, Gibson JME, McAdam JJ, Blacker K, Davies P, Day E, Emsley H, Ford G, French B, Gibson A, Leathley MJ, May C, O’Donnell M, Price C, Sutton C, Watkins CL. Implementing Telemedicine in Acute Stroke and the development of a Standardised Telemedicine Toolkit ASTUTE Project: Acute Stroke Telemedicine: Utility, Training and Evaluation. BMJ International Forum on Quality and Safety in Healthcare, April 2013, London, UK. [Poster].

Gibson JME, on behalf of the ASTUTE study team. Introducing Telemedicine in Acute Stroke: patients’ and carers’ perspectives. CPRU and RST team meeting, 14 March 2013, UCLan, Preston, UK. [Oral presentation].

French B, Lightbody CE, McLoughlin A, Fitzgerald J, Day E, Davies P, Emsley H, Ford GA, Jenkinson D, Leathley MJ, Price C, May C, O’Donnell M, Sutton CJ, Watkins CL. Implementing telestroke: developing a Standardised Telemedicine Toolkit. R&D Showcase, 22 November 2012, Royal Preston Hospital, Preston, UK. [Poster].

Gibson JME, McAdam JJ, Blacker K, Davies P, Day E, Emsley H, Fitzgerald J, Ford G, French B, Gibson A, Leathley MJ, Lightbody CE, May C, McLoughlin A, O’Donnell M, Price C, Sutton C, Watkins CL. Telemedicine for acute stroke: patients/carers views. World Stroke Day, 29 October 2012, Wigan, UK. [Poster].

Watkins C. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation. Visit to Hunter Stroke Service/HNEH Stroke Clinical Stream, 23 August 2012, Hunter Stroke Service, Newcastle, Australia. [Presentation and discussion].

Lightbody CE. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation: Developing a Standardised Telemedicine Toolkit. “One Year On” meeting at Telestroke Network, 18 July 2012, Garstang, UK. [Presentation].

Lightbody L, Gibson J, French B, McLoughlin A, Fitzgerald J, Gibson A, McAdam J, Day E, Davies P, Emsley H, Ford GA, Price C, May C, O’Donnell M, Watkins CL. Implementing Telemedicine in acute stroke. XXI European Stroke Conference, 24 May 2012, Lisbon, Portugal. [Poster].

McLoughlin A, McAdam J. ASTUTE: Staff and patient experiences. Meeting with UCLan overseas visitor Di Marsden, 18 May 2012, UCLan, Preston, UK. [Presentation].

Fitzgerald J. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation: developing a Standardised Telemedicine Toolkit. Meeting with UCLan overseas visitor Di Marsden, 18 May 2012, UCLan, Preston, UK. [Presentation].

Lightbody L, French B. Implementing telestroke - developing a web based toolkit. RASAG seminar, 17 April 2012, UCLan, Preston, UK. [Seminar presentation].

Lightbody L. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation: development of the Standardised Telemedicine Toolkit. Meeting with UCLan overseas visitor Professor Sandy Middleton, 2 December 2011, UCLan, Preston, UK. [Presentation].

Lightbody L. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation: developing a Standardised Telemedicine Toolkit. World Stroke Day, 28 October 2011, Wigan, UK. [Presentation].

Gibson JME, McAdam JJ, Blacker K, Davies P, Day E, Emsley H, Fitzgerald J, Ford G, French B, Gibson A, Leathley MJ, Lightbody CE, May C, McLoughlin A, O’Donnell M, Price C, Sutton C, Watkins CL. Research into telemedicine for acute stroke. World Stroke Day, 28 October 2011, Wigan, UK. [Poster].

Lightbody L. The use of telemedicine in assessing acute stroke patients. Advancing Stroke Practice Conference, 30 September 2011, Royal Preston Hospital, Preston, UK. [Presentation].

Lightbody CE, Ford G, Emsley H, O’Donnell M, May C, Leathley MJ, French B, Clarke J, McLoughlin A, Harris R, Heney J, Sutton C, Davies P, Blacker K, Day E, Watkins CL. ASTUTE: Acute Stroke Telemedicine: Utility, Training and Evaluation. 5th UK Stroke Forum Conference, 30 November-2 December 2010, Glasgow, UK. [Poster].

Further information

For further information about the project, please contact Liz Lightbody.

Tel. +44 (0)1772 893648

Project Staff

Liz Lightbody
Caroline Watkins
Michael Leathley
Jane Fitzgerald
Joanne McAdam
Jo Gibson
Alison McLoughlin

Collaborators and Partners

Professor Gary Ford, Newcastle University
Dr Chris Price, Newcastle General Hospital
Dr Hedley Emsley, Lancashire Teaching Hospitals NHS Foundation Trust
Dr Mark O’Donnell, Blackpool Wyre and Fylde Hospitals NHS Foundation Trust
Dr Paul Davis, North Cumbria University Hospitals NHS Trust
Professor Carl May, University of Southampton
Elaine Dey, Lancashire and Cumbria Stroke Network