Introducing Professor Chris Bladin
The Australian Stroke Alliance brings together a wide range of people who understand the importance of fast stroke treatment. We are preparing to deliver urgent, life-saving care across our vast continent.
So it makes perfect sense for us to tap into the expertise of people like neurologist, Chris Bladin. This pioneer of stroke telemedicine delivers expert stroke care to people living far from Victoria’s and Tasmania’s major metropolitan hospitals or specialist stroke units.
Chris, for over 10 years, you have worked with ambulance services and governments to offer urgent stroke care for those living far from city hospitals. Australians are keen to learn about telehealth. Can you give us the basics? Why do we need it?
Telehealth (in one form or another) has been around for a long time, in fact even dating back to the early days of the Royal Flying Doctor Service. It has been slowly increasing in usage but the arrival of the COVID-19 pandemic has seen a dramatic increase in its application.
New digital technologies and faster (NBN) internet speed now allow for a high-quality, virtual interaction between doctor and patient.
While we do very much enjoy the “warmth” of a face-to-face consultation, for many telehealth is preferable and is certainly convenient for both doctor and patient – although some may miss the many magazines in the doctor’s waiting room!
Tell us about the Victorian Stroke Telemedicine (VST) program.
VST is unique in Australia and has been active for over 10 years. It is currently operational within Ambulance Victoria.
It delivers high quality acute stroke care via telemedicine into 19 regional hospitals across Victoria and northwest Tasmania. Staff in an emergency department call a 1300 number that gives direct access to a stroke specialist who can then review brain imaging, and perform an audio-visual consultation with patient, family and clinical staff.
Advice is then given about the diagnosis, and decisions are made about the best treatment options. These may include clot-busting therapy (thrombolysis) or possibly even transfer to a larger metro hospital for more advanced stroke therapies.
A key element of VST is the close partnership with ambulance paramedics both at the pre-hospital level with rapid transfer to the emergency department, but also fast transfer to metro hospitals for time-critical treatment.
What is the most exciting aspect from a technological perspective?
The really cool thing is that it (mostly) just works! The technology is very simple to use – all the ED staff need to do is push the green button on the bottom of the screen and we (neurologists) “magically” appear.
Patients often comment on how they suddenly had “the stroke doctor” appear at the foot of their bed! Of course, no technology is always perfect, but we get great satisfaction from this clinical interaction, and having a real impact in these patients’ lives.
What is your role with the Australian Stroke Alliance and where will we be in five years’ time when it comes to stroke care for rural and remote Australians?
My role is to lead the delivery of the stroke telemedicine service, and to coordinate this with the many new innovative platforms that the Australian Stroke Alliance is developing.
This will be challenging as many of these areas have had little or no telemedicine integration before, and on such a large scale. For example, this will involve assimilating acute stroke care via telemedicine across air services (RFDS), hospital emergency departments, and mobile stroke units – how hard can that be?!
You’re quite a rare beast. Obviously, as a neurologist, you treat patients. What’s the greatest thing about being a neurologist who also conducts research?
Being a clinician researcher is a unique position, a wonderful opportunity, and in many ways the best of both worlds! We get to be involved in the initial bench-side research, the clinical trials that test out these new ideas, and finally the implementation of all this research for the benefit of the wider community.
No better example of this is the development of endovascular clot retrieval for stroke care – that is, the ability to introduce a very small catheter into a brain artery to remove a blood clot causing a stroke.
I was involved in the initial research with key members of the Australian Stroke Alliance. Following the publication of this ground-breaking research, the results were included in national and international stroke treatment guidelines.
In a short space of time, VST was able to start implementing this new treatment approach in all our regional hospitals. Given that implementation of research results traditionally can take well over 10 years, to be able to do this in less than 6 months was a remarkable achievement!
There’s a rumour that once when you were on the Victorian Telestroke neurology roster, you gave advice on a remote case from the back of an Italian motor scooter. Is this true? Any other novel locations have you consulted from?
Well, yes, this is partially true! While out at an Italian restaurant I received an urgent call to do a stroke telemedicine consultation for VST. I stepped out of the restaurant and fortunately was able to use the seat of a beautiful Vespa motor scooter parked nearby as a computer table – so appropriate, given the location!
On another occasion I did a consult from the car park of the MCG during the traditional Anzac Day AFL game between Essendon and Collingwood. That is the beauty of telemedicine – it defies borders and boundaries!
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