The stroke treatment service helping rural patients faster than major city hospitals

A game-changing new service has treated more than 3000 stroke victims across rural and regional NSW by eliminating the barriers of distance and time that stood between them and life-changing treatment.

The state government will on Tuesday announce its NSW Telestroke Service has been fully rolled out, offering patients around-the-clock rapid diagnosis and treatment. The service connects local doctors with highly specialised stroke physicians located hundreds of kilometres away in major hospitals via video consultations.

Brian Whelan is one of 3000 rural and regional patients treated by the NSW government’s Telestroke Service.Credit: Natalie Grono

Every year, about 19,000 people in NSW have a stroke and more than one-third of stroke patients hospitalised are from regional and rural areas. Fast diagnosis and treatment is critical to surviving stroke and preventing disability; the aim is to treat stroke within 60 minutes of a patient arriving at emergency.

Health Minister Brad Hazzard said the $21.7 million service was now preventing death and disability at 23 rural and regional hospitals, from Tweed and Lismore in the state’s north, to Broken Hill in the west, and Moruya and Bega in the south.

“When someone has a stroke it is absolutely vital they receive medical treatment as soon as possible, which is exactly what the NSW Telestroke Service delivers, no matter where you live in the state,” Hazzard said.

“Already more than 3000 people in NSW are better off for it, with many more patients to receive this life-saving treatment in the future.”

Brian Whelan was one of those patients.

When the then 79-year-old was rushed to Lismore Base Hospital in June 2022, he was diagnosed and started treatment within 35 minutes of being wheeled through the emergency department doors.

The physicians at Lismore used the service to video call a specialist neurologist at Gosford Hospital more than 650 kilometres away, who quickly diagnosed the bulge on Whelan’s brain scan as a blood clot, and recommended clot-busting treatment.

“I can’t thank them enough,” Whelan, now 80, said. “They saved my life.”

Brian Whelan has fully recovered from his stroke in June last year. Credit: Natalie Grono

The clot-busting treatment – known as thrombolytic therapy – involves injecting a medication called tissue plasminogen activator to break up the blood clot.

This type of treatment is a viable option only when a stroke is diagnosed within a small window of time and a stroke specialist can determine – via brain imaging – that the patient has a specific kind of blood flow pattern.

Whelan’s GP later told him that he was incredibly lucky to have received the treatment he did.

Whelan said: “Without it, [I] would likely have ended up needing full-time care in a nursing home.”

Instead, Whelan has largely recovered and is back to playing golf twice a week.

Professor Ken Butcher, medical director of the NSW Telestroke Service and director of clinical neuroscience at Prince of Wales Hospital, said there had been “a geographic bias towards access to treatment and better outcomes for stroke patients in metropolitan cities”.

“In rural and regional areas the care pathways have been very slow and many patients who potentially could have been treated weren’t,” he said.

“This service levels the playing field … It has really been a game changer.”

The service, which began in March 2020 at Port Macquarie and Coffs Harbour hospitals, has even surpassed some metropolitan services, with four in 10 Telestroke patients being treated within one hour of arriving at hospital – known as the “golden hour”, Butcher said.

He said the service’s median treatment time is about 65 minutes, significantly shorter than the roughly 90-minute median for most major hospitals across Australia.

Minister for Regional Health Bronnie Taylor said the service had transformed stroke treatment outside the major cities.

“Innovative models of care like Telestroke have transformed healthcare in rural and regional NSW, allowing patients to be treated faster than ever before in their communities,” she said.

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