Stroke is pervasive in South Carolina, particularly African Americans, who are 40 percent more likely to die from stroke than whites. A promising therapy for ischemic stroke called alteplase (tPA) is available, but adoption has been slow, particularly in rural communities. In 2008, the HSSC-supported SmartState Center for Stroke led by endowed chair Dr. Robert J. Adams, launched the REACH Stroke Network, which uses telemedicine and the internet to link stroke experts and advanced treatments at the Medical University of South Carolina (MUSC) to small and rural hospitals across the state that don’t have neurologists on staff. One of the goals of the REACH Stroke Network is to increase usage of tPA where appropriate.
In its first year of operation, the REACH MUSC succeeded in contracting with four hospitals: Georgetown Memorial Hospital, Waccamaw Community Hospital, McLeod Health, and Grand Strand Regional Medical Center. Within the five months, 53 REACH consults were completed, with 15 patients receiving tPA. Of McLeod Health’s 24 REACH consults, nearly half were treated with tPA. These early results demonstrate the realization of HSSC’s promise to the state that the organization would work to improve public health.
“Prior to the REACH Stroke Network, tPA was used in less than 1.5 percent of stroke cases, leaving patients with a high probability of disability or death. In these partner hospitals, the use of tPA to treat stroke has quadrupled. The potential for reversing the devastating effects of stroke in South Carolina is very real,” Dr. Adams says.
Today, the Greenville Health System and Palmetto Health are part of the REACH Stroke Network and are expanding expert stroke care across the state.