News Releases from Department of Health

One in five Hawaii residents will have a stroke during his or her lifetime. In fact, stroke is the third leading cause of death in our state and the number one cause of chronic adult disability. Of people under age 65, only 20% are able to return to full time employment after a stroke and 80% are permanently disabled.

Rapid intervention is key to improving outcomes for those who have had a stroke. There is only one FDA-approved medication for stroke that has been proven to improve outcomes: tPA or alteplase, which is a “clot buster” medication designed to restore blood flow to the brain.

Despite being on the market since 1996, only about 5% of stroke patients in Hawaii are treated with tPA and the chances of being treated with tPA range from 1% to 12%, depending on where a person lives in Hawaii.

This disparity in treatment rates is due to many factors, including drive times and public education.  Access to expert stroke consultation has been a contributing factor to low treatment rates on the neighbor islands and rural areas of Hawaii. To improve access to care, the Hawaiian Islands Regional Stroke Network was created to allow patients in remote locations to be seen by a stroke expert through telemedicine and receive early treatment.

Hawaii Department of Health Grant Improves Stroke Treatment Access
Hawaii is making progress in this issue as a result of the work of the Hawaiian Islands Regional Stroke Network. To date, 106 stroke telemedicine consultations have been conducted and 39 patients have been treated with tPA – the clot buster medication. Of those consultations, 39 patients were eventually transferred to The Queen’s Medical Center, while 67 patients were able to remain in their communities.

Since 2011, the Hawaii Department of Health’s Neurotrauma Special Fund has supported the Hawaiian Islands Regional Stroke Network with a grant. Mary Brogan, Administrator of the Developmental Disabilities Division, oversees this innovative and effective telemedicine program to address Hawaii’s unique geographical needs.

The grant covers two-way, synchronous audiovisual telemedicine equipment and maintenance costs to link neurologists who specialize in strokes at The Queen’s Medical Center with seven hospitals throughout the state. Using the telemedicine equipment, the grant also funds education sessions about treatment of strokes for medical providers at these sites as well as community education so that others can recognize the signs and symptoms of stroke and alert emergency medical services.

The first hospital site to participate in this program was Molokai General Hospital, which began in November 2011. Other participating hospitals include Wahiawa General Hospital, Hilo Medical Center, and The Queen’s Medical Center West Oahu, which was just activated this past January. Next: the installation of telemedicine equipment at Kona Community Hospital and Maui Memorial Medical Center has been completed and testing is will be underway. An affiliation agreement has been fully executed with North Hawaii Community Hospital and credentialing of the telestroke physicians is in progress.