Professor Tony Rudd: telemedicine could aid stroke aftercare

Guy’s and St Thomas’ NHS trust stroke consultant wants research into telemedicine for early supported-release for patients

Professor Tony Rudd, the lead clinician for stroke services at Guy’s and St Thomas’ NHS foundation trust, has said there needs to be more research into the use of telemedicine services to aid the early supported discharge of stroke patients.

“I think that telemedicine could be expanded. I am very keen to do research into it,” Rudd told Guardian Government Computing.

Applications of telemedicine in stroke treatment could be in releasing people from hospital earlier for rehabilitation in their own homes, Rudd said.

The NHS has developed an early supported-release model for stroke, but it is dependent upon therapists travelling to patients’ homes to deliver care.

“This is quite expensive if they have to travel a long time and spend more time travelling than they do treating the patients,” he said.

“But if you could employ more unqualified staff as therapy support workers, or train up relatives to do some of the rehabilitation which you could direct through telemedicine with a centrally-based therapist, I think that is a model that could be developed using telemedicine.

“Or group therapy with everybody dialing in, I think there’s potential there.”

Rudd, who is also a trustee for the Stroke Association and chairs its research and development strategy committee, said that St Thomas’ was the first hospital in the UK to use a telestroke service similar to that currently used by the Lancashire and Cumbria stroke network.

“The reason we wanted it was because there were only two consultants in stroke, and running a rota 24/7 with just two doctors can be quite stressful,” he said. “Having to get up at night to drive into the hospital not only wastes time, but also means you are not functioning brilliantly the next day.”

Rudd said that telemedicine is not a solution in itself, and has to be part of a reorganisation of stroke services, which includes the supply of other specialist equipment and staff training.

Since a transformation of stroke services in London created eight hyper-acute stroke units, telemedicine is no longer necessary in the capital.

Commenting on the government’s openness agenda in relation to a national audit of stroke services which he has run for the last 10 years, Rudd said: “What is being suggested is that every single piece of information we gather would immediately be made available to the public.

“This is not something that will be in any way helpful, because we have to go through processes of trying out the collection of data, collecting data on new aspects of care, which often hit problems in terms of realising that you have asked the question the wrong way, and that the data you get is not reliable in the way that it should be.

“I think that the requirement to put out everything into the public domain will stop us doing potentially interesting analysis because we will be frightened that that will be mis-interpreted.”

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