Pioneering new ideas and delivering science-based quality and systems improvement, the new Marcus Stroke Network will help develop life-saving strategies in stroke care and serve as an advanced model for a region impacted by stroke at disproportionate rates.
The Marcus Foundation has donated $15 million to establish the Marcus Stroke Network, a coordinated and collaborative effort among Grady Health System, Emory University School of Medicine, Boca Raton Regional Hospital and the American Heart Association/American Stroke Association to help reduce stroke disability and death rates in the Southeastern United States.
Powered by two comprehensive stroke centers at Grady and Emory and guided by the American Stroke Association’s science-based quality and systems improvement expertise, the Marcus Stroke Network aims to:
• Extend the world-renowned stroke expertise of the Marcus Stroke Network physician team by using innovative telemedicine technology to aggressively accelerate early and definitive stroke treatment.
• Establish the region’s first Mobile Stroke Unit, a specialized ambulance equipped with a CT scanner that allows medical teams to initiate lifesaving treatment for stroke patients before they reach the hospital.
• Implement a new paradigm of acute stroke care by initiating a direct “ambulance to angiography” approach.
• Support paramedics providing pre-hospital care to help with the diagnosis and triage of stroke patients to the nearest appropriate hospital, thereby optimizing treatment and community resources more effectively.
• Enhance the quality of care at participating Marcus Stroke Network hospitals and ensure long-term sustainability through a Regional Coordinated Stroke System of Care.
According to Marcus Stroke Network director Michael Frankel, MD, professor & director of vascular neurology, Emory University School of Medicine, chief of neurology and director of Grady’s Marcus Stroke and Neuroscience Center, vascular neurologists and other medical professionals at Emory and Grady will provide real-time stroke guidance to emergency medicine doctors at remote sites around the region, helping make diagnoses and treatment recommendations for patients who have had acute strokes.
A major focus of the Marcus Stroke Network is providing timely, accurate, and evidence-based quality care to stroke patients. This approach will be guided by the science and expertise of the American Heart Association/American Stroke Association. Assessing and treating stroke patients accurately and quickly is the goal of all entities involved in stroke care, and a result of the science and guidelines established by the American Heart Association/American Stroke Association.
Frankel and his colleagues have been working for more than 25 years on testing innovative and new treatments to reduce the death and disability of this common disease. His team helped pioneer treatments in stroke including mechanical thrombectomy and intravenous tissue plasminogen activator, commonly called IV t-PA or alteplase.
Both are now a standard of care for patients with ischemic stroke who meet specific treatment criteria in the emergency setting. Ischemic stroke, caused by cerebral artery blockage, is the most common form of acute stroke.
According to Frankel, the use of alteplase has not been effectively implemented at hospitals with limited capabilities in stroke care. The Marcus Stroke Network brings the stroke expertise of Emory and Grady neurologists to the bedside using a telemedicine approach to more rapidly identify patients who will benefit from treatment. Earlier treatment increases the chances of survival with minimal or no disability.
Stroke specialists working for the Network will be able to communicate with participating hospitals, using cutting edge real-time technology including digital video cameras, Internet telecommunications, tablets and other technology to rapidly assess and treat patients with acute stroke symptoms.
The system will also enable remote guidance of local follow-up care to optimize stroke prevention strategies. In addition, the Marcus Stroke Network’s mobile stroke ambulance will operate through Grady’s renowned EMS system, linking the Network doctors directly to patients in the field by utilizing an on-board CT scanner to facilitate the earliest treatment with alteplase possible for eligible patients.
Building on the success of Grady’s Marcus Stroke & Neuroscience Center in developing and testing the most cutting-edge treatments in acute stroke (e.g. mechanical thrombectomy), the new Network is implementing innovative strategies to more rapidly identify patients with acute stroke in the field and directly transport them to the neuroangiography suite (aka “direct to angio”).
According to Raul Nogueira, MD, professor of neurology at Emory University and director of Grady’s neuroendovascular service, “This approach substantially reduces the time from major arterial occlusion in the brain to definitive therapy with mechanical thrombectomy.” Nogueira says such approaches help minimize brain damage and promote recovery.
“We know that every second counts after a stroke and the mantra ‘time is brain’ is critically accurate. This innovative and collaborative effort will help expedite treatment for the people of this region and ultimately lead to lives saved,” says John Haupert, president and CEO of Grady Health System.
The Marcus Stroke Network, endorsed by Georgia’s Department of Public Health, will also provide a 24/7 call center serving as Georgia’s first centralized resource for paramedics to assist with decisions about diagnosing stroke and indicating to the paramedic the location of the nearest appropriate hospital destination for treatment.
Boca Raton Regional Hospital’s Marcus Neuroscience Institute will also be a collaborating partner in the new network.