ESCONDIDO -- Medical researchers are hoping a new clinical study involving Palomar Medical Center will speed up the diagnoses and treatment of acute stroke victims, which in turn could dramatically improve their prognoses.

The Escondido medical center is one of four California hospitals participating in a telemedicine program called Stroke Doc. It was launched at the local hospital May 24 by neurologists at UC San Diego.

The study uses high-resolution cameras, laptop computers and wireless technology to quickly link patients with acute stroke symptoms -- or those that began within the last three hours -- with neurologists who can determine whether the patients would benefit from time-sensitive treatments.

The program can be activated within seconds from anywhere with a wireless Internet connection, allowing neurologists to quickly diagnose and recommend treatments for acute stroke patients -- even from distant locations or cars.

Palomar Medical Center staff members said they are excited about the program because patients benefit from clot-busting drugs and some other stroke treatments only if they are administered within three hours after stroke symptoms begin.

"The hope is that we would instantly have a decision on whether (the crucial treatments) should be administered, as opposed to calling the neurologist on call, in the middle of the night, say, and he has to get up, get dressed and drive to the hospital," said Kim Colonelli, director of Palomar's emergency and trauma services. "And the question is whether having the neurologist immediately available rather than waiting for him to get here is going to make a difference."

Funded by federal grant

Telemedicine is a growing field that uses technological advances to develop new ways of providing medical care. The approach has revolutionized cardiac care during the last 20 years, said Dr. John Fredericks, an emergency department physician at Palomar.

Researchers are just beginning to apply the method to neurology, he said.

Dr. Brett Myer, co-director of UC San Diego's Stroke Center and a Palomar Medical Center neurologist, is lead researcher for the Stroke Doc program. The study, which is expected to last at least two years and involve 400 patients, is being paid for with part of a multimillion-dollar grant the National Institute of Health gave UCSD for several clinical trials, he said.

Pioneers Memorial Hospital in Brawley, El Centro Regional Medical Center and Twin Cities Community Hospital in Templeton are the other study participants.

Given soon enough, the clot-busting drugs and other treatments can sometimes reverse a stroke's effects, Myer said.

A hospital's location, lack of access to a neurologist, patients' uncertainty about the need to seek medical help, and other factors can delay such evaluations, though, he and Colonelli said.

"Time is brain, and every minute it takes to evaluate and/or consider therapy for acute stroke is a minute that brain tissue is at stake," Myer said.

Remote diagnosing

Those coming into Palomar's emergency room with acute stroke symptoms typically are evaluated first by an on-duty physician. If the doctor decides the patient may be a candidate for the clot-busting therapy, the staff calls a hotline at the stroke center, Colonelli said.

The study is a random one, so not every patient is accepted into it. Those who are not accepted get treated in the traditional manner.

When the program's computer system gives the go-ahead, hospital staff members wheel a rolling Stroke Doc unit into position at the patient's feet. Showing one of the units to visitors recently, Colonelli pointed out the camera, a computer monitor and audio system mounted on the 6-foot-high unit's central pole.

By logging onto a secure Web site from their end, Myers and other researchers can use a remote to point the camera toward any part of the patient's body while talking to the patient and staff via the audio system.

The monitor brings the patient "face-to-face" with the neurologist, Colonelli said.

"It eliminates the need for them to leave an office full of patients and rush over here to a patient in the hospital here," she said. "They can follow up with that patient later on at the hospital."

So far, Stroke Doc has been used with about 50 acute stroke patients, including seven at Palomar. Emergency-room nurse Debbie Samrady said the program worked beautifully with a recent patient whose case she was familiar with.

"Within a couple minutes, he was diagnosed," she said. "All we had to do is put the camera in front of him. It's like getting a second opinion right away from an expert."

Myer said a young male stroke victim in the study now shows little or no disabilities after being quickly diagnosed and started on treatment via Stroke Doc.

Colonelli said Palomar administrators are optimistic the research study will improve the medical care for stroke patients throughout the hospital's service area.

Fredericks, the emergency room physician, said he saw another potential benefit.

"The real advantage for telemedicine is it can bring health care to rural areas," he said.

While other telemedicine programs have been tried with stroke victims, this one is the first that does not tie a neurologist to a specific work station or site, Myer said.

"This is the most exciting thing I've ever been a part of," he said. "The ability to care for patients that we otherwise would not be able to help is one of the most rewarding things I've ever done."

Contact staff writer Andrea Moss at (760) 739-6654 or amoss@nctimes.com.