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Trendsetters: Reaching Rural Patients

In the not-too-distant past, many rural Georgia stroke victims missed out on a treatment that could have saved their lives and reduced long-term damage from their strokes. By the time they went to the closest hospital and were transferred to a larger suburban or urban hospital, they were typically outside the three-hour window required for receiving the clot-busting treatment known as tPA (tissue plasminogen activator).

But thanks to technology and software provided through Alpharetta-based REACH Health, more people are able to receive lifesaving treatment in the state’s rural areas more quickly.

Stroke is the fourth leading cause of death in Georgia and a leading cause of disability. According to the Georgia Department of Public Health, our state had 4,194 stroke deaths and 19,847 stroke hospitalizations in 2015, the latest year for which data are available.

The tPA treatment is highly effective, but to prescribe it, neurologists must view a CT scan to confirm blockage in the brain. Under the wrong conditions, patients could die from tPA treatment, which explains why stroke patients don’t automatically receive it in rural emergency rooms.

Five physicians at Augusta University, formerly Medical College of Georgia (MCG), were determined to make lifesaving changes that would allow faster diagnosis and treatment for rural stroke patients. In 2003, they launched one of the nation’s first telestroke programs, which allowed MCG neurologists to connect with eight hospitals in East Central Georgia via fairly primitive audio and video hardware.

“The concept was to be able to see the patient and images of the brain rapidly so our neurologists could make the decision to treat with tPA and then transfer the patient to MCG if necessary,” says Grant Kohler, co-founder and vice-president of innovation at REACH Health. “I was a network and systems administrator in the neurology department at the time, and we were not thinking of this as a business. We were trying to help patients.”

After hospitals outside Georgia began to express interest in the MCG telestroke program, Kohler and REACH Health co-founder Dr. David Hess realized they needed to embark on the process to commercialize it. “This was the first project ever spun out of the medical college,” Grant remembers. “Word-of-mouth and other factors forced us to turn it into a business.”

From the start, Kohler and Hess envisioned REACH Health as a telemedicine software company designed for physicians’ ease of use in evaluating patients at remote locations. What makes REACH Health different from other telemedicine initiatives is the comprehensiveness of its three software components.

Today’s version, known as REACH 5.0, is web-based and combines sophisticated video and audio with a medical imaging platform and documentation tools. It allows physicians to see and talk to far-flung patients, review their scans and other images and create documentation notes that can be shared with other physicians, facilitating collaboration and ensuring that data about each patient goes to the proper place.

“It was designed by physicians for physicians, so everything is in one interface,” Kohler explains. “All they need is a headset and access to a web browser.”

What began in the medical school with a handful of physicians and information technology professionals is now a company with more than 40 employees and headquarters in Alpharetta. Kohler says REACH Health relocated there about six years ago to take advantage of the concentration of engineering and IT talent and to attract executive leaders.

REACH Health has evolved its telemedicine software to assist physicians in the remote diagnosis and treatment of additional specialties, including general neurology, behavioral health and pediatrics, with more specialties on the horizon. The company also has expanded the types of care settings in which its software can be used. These include clinics, schools, jails, skilled nursing facilities and emergency departments.

Today, many of the nation’s most successful telemedicine networks run on REACH Health software. Augusta University’s telestroke network now encompasses 29 facilities from Barrow County in northeast Georgia to Tift County in the south and east into Aiken, S.C. Other telemedicine networks powered by REACH Health include St. Dominic Hospital in Jackson, Miss.; Medical University of South Carolina in Charleston; Penn State Hershey Medical Center in Hershey, Penn., and Temple University in Philadelphia.

“Today, our telemedicine customers are reporting some of the best industry metrics, including some of the highest tPA administration rates,” says Kohler. “We remain true to our original approach, which is to help doctors bring the right care to the right patient at the right time and place.”

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