The Case: Uncovering Stroke During a Tele-Behavioral Health Evaluation

A 54-year-old male had been discharged from an inpatient behavioral health unit. He returned home but just one day later became agitated and combative. His wife — concerned about his behavior and suspecting behavioral health issues — called law enforcement to help, and he was brought to the hospital emergency department.

Law enforcement initially suspected drug use and considered arrest and transport to jail, but the patient’s wife insisted it was a mental health issue. After she signed involuntary commitment papers, the patient was referred to a behavioral health evaluation with an Access TeleCare Psychiatrist who was covering the hospital emergency department through telemedicine. Instead of assuming a behavioral health or substance-related issue, the doctor conducted a broader clinical evaluation. Recognizing signs that suggested stroke, he immediately contacted the onsite physician and recommended urgent screening for stroke or serotonin syndrome. A CT scan confirmed a large vessel occlusion. The patient was transferred for advanced stroke care — and survived.

Collaborative Virtual Care Plan and Clinical Follow-Through

Though originally called to conduct a behavioral health evaluation, the Access TeleCare Psychiatrist extended beyond his specialty to ensure the patient’s medical status was fully evaluated. He coordinated with the attending on-site physician and escalated care immediately. The virtual solution enabled a rapid response and life-saving care.

“This doctor didn’t just assume this was a behavioral health case. He looked deeper, acted fast, and saved a life.”

– Michael Genovese, J.D., M.D.
Access TeleCare’s chief medical officer of Behavioral Health

Outcome: Virtual Behavioral Health Improved Patient Safety and Care Continuity

Because of the physician’s clinical judgment and commitment to seeing the whole patient — not just the
presenting issue — he likely saved the man’s life. The facility later contacted Access TeleCare to express
deep gratitude for his actions.