Customer Interview Reports Customer Interview 1Project Description For this interview, we discussed the practicality and market need for a tool to aid in the remotediagnosis of strokes via telemedicine. The tool is a wearable device worn on the face that allowsa specialist to remotely assess the visual fields of a patient.Interviewee: Mary Britton | Stroke Coordinator, Promedica Health SystemInterview Summary Mary Britton, the stroke coordinator for the regional NW Ohio area, was chosen for thisinterview due to her extensive knowledge on the topic of strokes and her familiarity with theneed for a swift diagnosis. She also has experience with a wide variety of stroke and post-strokecare techniques. Her experience and perspective will be helpful to us for finding a niche for theproduct within the diagnosis, analysis, and recovery process of stroke patients.After explaining the utility of the device to Mary, she offered her opinions on how thedevice could be implemented within the stroke diagnosis process. She stated that the use oftelemedicine for the diagnosis of strokes is growing tremendously. Currently, EMT’s in the fieldare using iPads to connect with specialists from the ambulance. They are able to communicatewith the neurologist and ask questions as well as take instructions to help diagnose the patient onthe way to the hospital. There is even a mobile stroke unit that includes specially-trained EMT’sand an ambulance with a working CT scanner inside. These tools have improved the time todiagnosis and time to treatment for severe or “acute” stroke cases. In general, if the EMS thinkthe patient is experiencing a stroke, preparations are made at the hospital while the patient is intransport to allow them to be diagnosed and treated as quickly as possible. This includesprepping the CT scanner and IV access for the incoming patient. In almost all cases that an EMTsuspects a stroke, the patient undergoes a CT scan. The CT scan is a much more reliable test thathelps doctors determine if the stroke is Ischemic or Hemorrhagic. Ischemic means there is ablockage in the brain, hemorrhagic means there is bleeding in the brain. After the CT Scanconcludes that the stroke is not Hemorrhagic, and the patient’s last known normal was less than 4hours before diagnosis, the patient is given TPA, a clot-busting injection. This breaks up the clotthat is causing the Ischemic Stroke. This distinction is important as TPA could be life threateningto a hemorrhagic stroke victim.There is a standard field diagnosis technique, called the National Institute of Health(NIH) Stroke Scale, EMT’s use this technique to preliminarily diagnose the severity of the strokein the patient. This stroke assessment works well enough for severe strokes and yields a strongconfidence that a stroke is occurring. Mary indicated that since this test reliably indicates a strokeis occurring, the Telestroke Goggles would not improve this process. She did explain to us that amore feasible and useful application for the Telestroke Goggles: the case of the minor stroke.Often times, if a patient is not exhibiting the symptoms of a severe stroke, they are notimmediately transported to Toledo hospital and are monitored for 23 hours in the rural clinic.Since it is not as easy to detect if the patient is having a minor stroke, the tool can be useful toget a more accurate depiction of the visual field loss of the patient. At these clinics there are nospecialists available so the telemedicine aspect of the device will allow nurses to apply thedevice and a specialist can carry out the test remotely. Mary also said the device could be usedpost-treatment to determine if the visual field loss has improved in patients. The minor strokecase can often be confused for post-migraine, post-seizure, or encephalopathic symptoms.Patients can even misleadingly exhibit stroke-like symptoms if they have a psychologicacondition called conversion disorder. Having this device at the fingertips of these clinics willallow the minor stroke cases to be easily sorted out from the false positives.Conclusion Overall, Mary’s comments helped us realign our market focus towards the minor strokecase. She did not have any improvement comments on the device itself. She believed theprinciple diagnosis method of the device to be correct and that the device would serve a marketneed in a rural clinical setting.
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