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Cortland Regional Medical Center forges telestroke partnership with Upstate University Hospital

By Eric Reinhardt


Mark Webster is president and CEO of Cortland Regional Medical Center, which in July started a partnership with Upstate University Hospital’s Comprehensive Stroke Center to provide patients access to stroke care. Photo credit: Cortland Regional Medical Center

CORTLAND, N.Y. — Cortland Regional Medical Center (CRMC) is partnering with Upstate University Hospital’s Comprehensive Stroke Center to ensure patients have access to stroke care.

When patients with stroke symptoms arrive at the CRMC emergency department, physicians are able to consult with neurologists at Upstate through a new telemedicine program.

The partnership started July 1, says Mark Webster, CEO of Cortland Regional Medical Center.

Cortland Regional is one of five New York hospitals that have recently partnered with Upstate to provide telemedicine support for stroke care. 

Besides CRMC, Claxton-Hepburn Medical Center in Ogdensburg, River Hospital in Alexandria Bay, Carthage Area Hospital, and Samaritan Medical Center in Watertown have also teamed up with Upstate for the same service, according to the Upstate website.

“Upgrade” the service
CRMC had a previous telephonic neurology service, but it wasn’t telemedicine, says Webster. 

The service was based outside the Cortland area, and those using it didn’t know if they’d be speaking with someone in Kansas City or someone in Syracuse, he noted.

“There wasn’t a lot of continuity and there was no consistency … we decided we wanted to upgrade that,” Webster added.

CRMC spoke with both Crouse Hospital and Upstate University Hospital in Syracuse, both of which offered programs that Webster described as “very strong.”

“We ended up choosing Upstate for a telemedicine program and [it has] a comprehensive stroke center,” he adds.

Webster spoke with HealthCare Provider on Oct. 19.

The partnership for the clinical-service agreement doesn’t involve a financial arrangement, according to Webster.

“There’s no movement of money between the organizations with this clinical collaboration,” he says.

How the partnership works
The technology connects Cortland Regional physicians to neurologists in Syracuse, allowing them to talk with the patient and share other vital information via videoconference. 

Within minutes, an Upstate neurologist will be able to review the CT scan, examine the patient, and determine the best course of treatment in consultation with Cortland Regional emergency physicians.

“Acute stroke care is both complicated and very time critical. This partnership will enable us to get guidance from the stroke experts at Upstate so that we can provide the best possible care to our patients here in Cortland without delay,” Dr. David Wirtz, medical director of the emergency department at Cortland Regional Medical Center, said in a CRMC news release.

Patients can have two types of strokes, according to Webster. One involves bleeding and the other involves a clot.

Those involving bleeding require treatment from neurosurgeon in a larger medical complex. 

Those involving a clot will require a determination on whether to provide treatment in Cortland or to transfer the patient to Syracuse.

In treating stroke, time is a key element, according to Webster.

“The longer the brain goes without oxygen, the more damage there’s going to be,” he notes. 

“About 1.9 million neurons die every minute after a large vessel occlusion or stroke,” Jennifer Schleier, a registered nurse and program manager of Upstate’s Comprehensive Stroke Center, said in the CRMC release. “Having access to an Upstate neurologist at a moment’s notice can make all of the difference in the world to the outcome of that stroke patient. We want to give stroke patients the best chance at not only survival but for a life with little or no disability.”

The standard protocol for ischemic (non-hemorrhagic) stroke treatment is intravenous tPA, a clot-busting drug that can provide the best benefit to patients if administered within a short time after the first signs of stroke.

“This new technology will also allow us to deliver high quality care without the stress of transferring patients unnecessarily,” Tammy Aiken, Cortland Regional’s director of emergency services, said.

CRMC’s emergency department will be encouraged to keep “uncomplicated” patients in Cortland, the hospital said. 

Should a patient need required transportation to Syracuse for advanced care, a specialist at the Upstate Comprehensive Stroke Center will provide support.

Upstate designation
Upstate University Hospital in January 2015 earned certification as a Comprehensive Stroke Center from Milford, Ohio–based DNV GL Healthcare Inc., a hospital accreditation organization.

The designation reflects the highest level of care and treatment that hospitals can provide for serious stroke events.

Upstate University Hospital is the only hospital in Central New York to earn such a designation from DNV for its stroke care, according to a Jan. 20, 2015 news release from the hospital. 

Upstate is also recognized as a primary stroke center as designated by the New York State Department of Health, according to the release.

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