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Hendry Regional Medical Center TeleStroke Case Study

By: | Tags: , , , , , , | June 16th, 2026

HRMC partnered with TeleSpecialists in 2023 to close gaps in AIS care and deliver the gold standard of stroke care locally.
Remote specialist access, clinical education, and standardized workflows reduced average DTN time by 43% and increased the GWTG-Stroke composite score from 74.9% to 95.1%.
HRMC achieved Acute Stroke Ready certification and increased annual stroke admissions from 0 in 2022 to 6 in 2025, creating a scalable model for rural hospitals.

BACKGROUND

Hendry Regional Medical Center (HRMC) is a 25-bed Critical Access Hospital in Clewiston, FL, serving rural Hendry County, a medically underserved community where the stroke age-adjusted death rate significantly exceeds state norms. Rural residents face a 30% greater risk of stroke mortality compared to urban counterparts.

THE CHALLENGE

HRMC faced compounding barriers that made high-quality acute stroke care extremely difficult to deliver:

  • No on-site neurologist to evaluate patients and initiate thrombolytics
  • Late recognition of stroke symptoms at triage
  • Inconsistent stroke alert activation across departments
  • Documentation gaps in time-stamp accuracy, NIHSS scoring, and dysphagia screening
  • High interfacility transfer rates that disrupted stroke care continuity
  • A GWTG-Stroke Rural Overall Composite Score of 74.9% in 2023, well below national benchmarks

THE SOLUTION

HRMC partnered with TeleSpecialists to implement a structured teleneurology program in two phases. The approach combined virtual board-certified specialist access with deep clinical education and data-driven workflow refinement.

Phase 1: Stroke Workflow Redesign (2023-2024)

  • Designated a stroke champion to lead team education on workflow and national best practices
  • Delivered targeted training for nursing staff on early stroke symptom recognition at triage
  • Established EMS pre-arrival notification with concurrent TeleSpecialists alert for any BEFAST+ case identified in the field
  • Implemented early medication mixing on verbal orders for identified thrombolytic candidates

Phase 2: TeleNeurology Rounding Program (2024-Current)

  • Launched structured daily virtual rounds with TeleSpecialists neurologists for coordinated inpatient stroke management
  • Integrated real-time telemedicine assessments directly into the ED stroke alert workflow
  • Implemented chart audits evaluating documentation accuracy, imaging timeliness, and thrombolytic decision-making
  • Established monthly multidisciplinary reviews to monitor performance trends and refine workflow barriers in real time

THE OUTCOMES

Following the implementation of the TeleNeurology program, HRMC documented measurable improvement across every tracked indicator. Door-to-needle median time improved from 63 minutes in 2023 to 36 minutes in 2024. The 2025 median of 44 minutes reflects five of six cases involving AHA-allowable delays related to shared decision-making and hypertension management; year-to-date 2026, the median has returned to 36 minutes. The GWTG-Stroke Rural Overall Composite Score rose from 74.9% in 2023 to 95.1% in 2025. Acute ischemic stroke admissions grew from one in 2022 to six in 2025, reflecting HRMC’s growing capacity to evaluate, treat, and retain stroke patients locally rather than transfer them out.

IMPACT

The partnership created meaningful impact across three dimensions: for patients, for the hospital, and for the broader rural community it serves.

Patient Impact

  • Specialist-level neurological evaluation within minutes, without transfer
  • Every 15 minutes saved in DTN time preserves measurable brain function
  • Patients remain near family and familiar providers during critical recovery

Operational Impact

  • Eliminated the default of transferring all suspected stroke patients
  • Staff competency in AIS response improved significantly across all departments
  • Documentation quality and regulatory compliance improved across all tracked metrics

Community & Equity Impact

  • Hendry County residents can now receive the same stroke care standard as major medical centers
  • Reduction in transfers addresses a key driver of rural health inequity
  • HRMC’s model demonstrates a replicable framework for rural hospitals nationally
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