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Stroke Survivors

TeleStroke Services & Emergent TeleNeurology Program

What Is TeleNeurology

TeleNeurology, also called TeleStroke, is the process of a doctor with advanced experience in strokes, or vascular neurologist, virtually examining a suspected stroke patient over video. The goal of TeleStroke evaluation is to quickly evaluate and treat patients to improve the hospital’s reaction time to emergency stroke care and patient’s outcome.

Time is of the essence when saving brain cells. Emergency acute stroke support with our TeleStroke services can save lives and allow for better stroke care. Hospital neurologists are at a premium, with neurology as one of the country’s most understaffed medical fields. This shortage puts stroke patients at risk of not seeing a neurologist in time. TeleSpecialists provides focused emergent neurology services, including TeleMedicine for stroke, to hospitals across the United States — anytime, anywhere.

Our TeleNeurology Program

TeleSpecialists is proud to be a leader in TeleStroke and Emergent TeleNeurology services. Every second counts during a stroke, and an on-call TeleStroke neurologist with TeleSpecialists can be connected directly to the Emergency Department via telemedicine in an average of four minutes. Rapid reaction time and treatment can dramatically improve patient outcomes and ultimately save lives. Our TeleStroke solution brings extensive clinical stroke experience from highly trained TeleNeurologists directly to your healthcare facility via telemedicine.

How TeleNeurology Works

We seamlessly integrate our TeleNeurologists with your hospital’s stroke team and ED staff to create a streamlined and effective TeleStroke response. TeleStroke Alert services ensure rapid assessment and treatment for EMS stroke patients. With prearrival Stroke Alert notification, ED staff can mobilize and contact TeleSpecialists so that a TeleStroke response is available almost as soon as EMS brings the patient in. This capability places a board-certified, stroke-trained neurologist on-screen at the patient’s bedside in an average of three minutes. Patients who receive rapid triage and treatment regularly experience drastically improved outcomes and higher quality of life.

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This sample was taken from a hospital division that went live with TeleStroke services in seven of their hospitals. Most locations averaged at least a 50% drop in DTN time.

While our TeleStroke program can be adjusted to fit your hospital’s needs, here is an example of TeleStroke applications and how virtual stroke services for healthcare facilities can work for you:

  • If an EMS patient is presenting with stroke symptoms, the hospital staff calls the TeleSpecialists Rapid Response Center. A physician will be on-screen in an average of three minutes, providing immediate access to a neurology consult.
  • As ED staff prepares for an incoming Stroke Alert, the charge nurse retrieves the TeleNeuro cart to meet the patient in the EMS hallway. This step allows a TeleNeurologist to continue to follow the patient throughout the entire Stroke Alert, providing a remote evaluation of acute stroke patients.
  • EMS reports to the ED nurse, physician, and TeleNeurologist via the TeleNeuro cart.
  • The ED physician performs a brief exam, which is observed by the TeleNeurologist. Both physicians confer and agree to proceed as Stroke Alert with the goal of rapid progression to CT.
  • The patient is swiftly transferred to CT while the ED physician enters Stroke Alert orders for Stat CT of the brain under the Stroke Alert protocol.
  • Stroke Alert ensures a radiologist is tagged and the patient receives priority reading status.
  • The TeleNeurologist can view the CT in real time and make recommendations.
  • The radiologist, TeleNeurologist, and ED physician discuss the CT results, and a decision is made to give an IV injection of recombinant tissue plasminogen activator (tPA). Improving Door-to-Needle time for stroke patients is key to recovery.
  • Nursing takes the premixed tPA. Two nurses verify the dosing, and tPA begins.
  • A nurse assists the TeleNeurologist, and a focused neuro exam and full NIHSS is performed.
  • The ED physician, TeleNeurologist, and ED staff continue with an in-depth neuro assessment, decision on tPA administration, and transitioning the patient to the inpatient setting.

Emergent TeleStroke Services

With our TeleStroke protocols in place, a TeleNeurologist can be there at minute zero.

TeleSpecialists was founded on the principles of lean management and a focus on developing protocols to provide seamless acute neurology response, among other benefits. During implementation of our TeleStroke services, we identify and coach your team of TeleStroke program stakeholders, which may consist of representatives from EMS, ED nursing leadership, Laboratory, Pharmacy, Radiology, Rapid Response, Staff Neurologists, and Stroke Coordinators. Together, we build a state-of-the-art TeleStroke and Emergent TeleNeurology program within your hospital’s infrastructure, with our neurologists responding to Stroke Alerts and other STAT neurology consults, including acute encephalopathy, syncope, Bell’s palsy, and acute altered mental status.

VALUE

  • Increase percentage of Door-To-Needle times below 45 minutes.
  • Increase thrombolytic utilization rates, up to 20%.
  • Improve patient retention.
  • Increase regional market share and improve regional reputation.
  • Enhance patient care.

QUALITY

  • TeleSpecialists provides clinical programmatic support beyond teleconferencing and recommendations. Our TeleNeurologists take charge of the Stroke Alert consult, writing orders directly into your EMR, and staying on screen through the administering of alteplase.
  • Implementation of the acute care protocols and criteria for administration of alteplase.
  • Extensive educational modules for a state-of-the-art program.
  • Implementation of order sets and protocols to meet the “Get with the Guidelines” metrics established by the American Stroke Association.
  • TeleSpecialists utilizes lean management principles: a process improvement methodology that focuses on removing ‘waste’ from a process and solving problems through the application of a standardized workflow.
  • TeleSpecialists earned accreditation from The Joint Commission in December of 2019.
  • TeleSpecialists is the only telemedicine company to earn the ISO 9001:2015 certification, issued through Bureau Veritas.

EFFICIENCY

  • The TeleSpecialists program creates efficiencies through process improvement within the infrastructure of the Emergency Department.
  • TeleSpecialists provides TeleStroke consultation services to develop on-site rapid triage and second-level assessment protocols to help rapid triage and early stroke team notification.
  • TeleSpecialists provides an in-house hotline number that can be used for quick neurologist on-screen response.
  • With the use of Value Stream Mapping, implementing a process improvement plan within the process flow of the Emergency Department, TeleSpecialists aims to reduce Door-To-Needle times by implementing simple process improvement measures.
  • If the minimum specifications are in place, your hospital will have the option to use your existing cart and video platform, with no specific software or carts to purchase from us or install. If your team is just starting out, we are happy to advise your team regarding technology selection.

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Other Services Provided by TeleSpecialists

TeleSpecialists has responded to the growing needs of hospitals like yours, and provides services in the following areas as well via telemedicine:

Contact Us

Are you ready to take your stroke program to the next level? Contact us today and learn how you can integrate our services today and provide a quality-focused, consistent ad data driven neurology program into your hospital today.

CONTACT US

Nattasha Acevedo, MD

Dr. Acevedo received her medical degree from the Ponce School of Medicine in Puerto Rico and did her neurology residency at Montefiore Medical Center in New York. She went on to do a clinical neurophysiology fellowship at Emory School of Medicine in Atla nta, Georgia and then joined private practice in Fort Myers, Florida. She currently resides in San Juan, Puerto Rico. She likes running, paddle boarding and spending time with family.
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Bernadette Borte, MD

Dr. Borte received her medical degree from St. Matthew’s University School of Medicine in Grand Cayman. She completed her neurology residency at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Her areas of interest include inpatient neurology and acute stroke. When not working, she enjoys spending time outdoors with her family. Dr. Borte joined the TeleSpecialist family in March of 2019.
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Mazen Almidani, MD

Dr. Almidani is board certified in pediatrics by the American Board of Pediatrics and board certified in epilepsy, as well as neurology with special  qualification in child neurology by the American Board of Psychiatry and Neurology.  Dr. Almidani is happily married with 4 children. His oldest son has autism and his daughter has complicated seizures; both were a drive for him to become a neurologist. Dr. Almidani enjoys soccer, running and spending time with his family. He is very involved with his sons’ therapy and helping with daily challenges. He is double board certified in Pediatric and Adult Neurology and Epilepsy. He sees children and adults. He also participates in charities for children in Syria who may be underprivileged and/or affected by the war. Dr. Almidani joined TeleSpecialists in August 2020.
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Amanda Cheshire, MD

Dr. Cheshire received her medical degree from the University of Louisville School of Medicine in Louisville, Kentucky. She completed her neurology residency at the University of Cincinnati Medical Center in Cincinnati, Ohio. She did a fellowship in neurophysiology at the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Cheshire is double board certified in neurology and clinical neurophysiology. She enjoys traveling, reading and music. She currently resides in Viera, Florida.  Dr. Cheshire joined TeleSpecialists in June 2019.
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Jessica Floyd, MD

Dr. Floyd completed her neurology residency at Mayo Clinic in Jacksonville, Florida followed by fellowship training in clinical neurophysiology with focus in EEG and epilepsy at the Medical University of South Carolina in Charleston, South Carolina. She has particular interest in hospital neurology and patient education as well as the blossoming specialty of lifestyle medicine. She strives to take advantage of every encounter with patients and medical staff to empower them to do their own research into how daily thoughts, choices, and habits can add up to create greater and longer-lasting brain and neurologic health for ourselves and our loved ones. She lives in Florence, South Carolina with her awesome husband of 13 plus years and three beautiful children. She is an avid yogi, astrologer, and lover of food and all things neurology! Dr. Floyd joined the TeleSpecialist family in July 2017.
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Nancy Futrell, MD

Dr. Futrell received her medical degree from the University of Utah in Salt Lake City, Utah. She also did her neurology residency at the University of Utah as well as a research fellowship in cerebral vascular disease at Jackson Memorial Hospital in Miami, Florida. She currently resides in Salt Lake City, Utah. She has authored 2 books and 50 peer reviewed papers. 
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Rebecca Jimenez-Sanders, MD

Dr. Jimenez Sanders received her undergraduate degree from Emory University, and her medical degree from the San Juan Bautista School of Medicine in Puerto Rico. She completed her neurology residency at the University of South Florida in Tampa, Florida, where she also did a specialized headache medicine and facial pain fellowship. She currently resides in Tampa, Florida with her husband and her two daughters. She is also fluent in Spanish and Italian languages, and enjoys photography, baking, boating, and biking.
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Cory Lamar, MD

Dr. Lamar received his medical degree from Meharry Medical College in Nashville, Tennessee. He completed his internship and residency at Wake Forest Baptist Health in Winston Salem, North Carolina. Following residency, he completed a clinical fellowship in neurophysiology, with a concentration in epilepsy. He currently resides in Florida and enjoys outdoor activities.
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Clifford Meyers, MD

Dr. Meyers received his medical degree from Brown University in Providence, Rhode Island and his MBA from the Simon School of Business at the University of Rochester in Rochester, New York. He completed his neurology residency at the University of Rochester, where he also did a neurophysiology fellowship. Dr. Meyers resides in Webster, New York with his wife and daughter. When not doing teleneurology, he enjoys playing sports with his wife and daughter.
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Tao Tong, MD

Dr. Tong received her medical degree from the University of Miami School of Medicine in Miami, Florida. She completed her neurology residency at Jackson Memorial Hospital in Miami, Florida, where she also did a neuromuscular/EMG fellowship.  She currently resides in College Station, Texas. Dr. Tong is married with two boys. She enjoys spending time with her family, traveling and reading.
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Shubhangi Chumble, MD

Dr. Chumble attended BJ Medical School. She is a board certified neurologist with a subspeciality interest in sleep medicine. Dr. Chumble did her residency at Howard University in Washington DC and has practiced neurology since 2001 in private and corporate settings. She lives in Melbourne, Florida and loves the sunshine state. Her hobbies include yoga, meditation, cooking , traveling and meeting new people. She also loves to do stained glass, pottery and painting. She joined TeleSpecialists in June 2019.
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