Telestroke units helped increase the number of rural patients treated and deliver treatment faster, according to a 10-year evaluation published in the journal Stroke.
At the studied telestroke units in Germany, regional hospitals had 24-hour access to vascular neurologists, including evaluation of brain imaging and patient examination via videoconferencing when needed.
Twelve regional hospitals with neurology and neurosurgery departments entered the telestroke program in 2003. That number had grown to 15 by 2012, with 31,864 consultations provided, according to an announcement. During that time, the percentage of patients with symptoms of stroke or mini-stroke who were treated through the telestroke units grew from 19 percent to 78 percent.
The 10-year evaluation found:
- The number of patients receiving the clot-busting drug tissue plasminogen activator (tPA) for ischemic (clot-caused) stroke rose from 2.6 percent to 15.5 percent
- The median time between a patient's arrival at a regional hospital until tPA was administered fell from 80 minutes to 40 minutes
- The median time between onset of stroke symptoms and receiving tPA fell from 150 minutes to 120 minutes
During the same decade, the number of patients transferred from regional hospitals to stroke centers declined from 11.5 percent to 7 percent.
Researchers from the University of Pennsylvania School of Medicine have found that a telestroke program based in Oregon was able to increase access to stroke care by 40 percent.
In addition, telestroke network at Penn State Milton S. Hershey Medical Center has doubled in size since it was launched in 2012 with five partners in Central Pennsylvania and four more partner hospitals are expected to join over the next six months.
Neurologist Raymond Reichwein explained in a FierceHealthIT interview that it had boosted care quality at the regional hospitals and helped them more quickly identify patients who really need to be transferred. Yet he talked about using data for process improvement.
"The technology, the bandwidth and the interaction are all important, but if you don't have the right structure, the right personnel, the right pathways or protocols--and if you have gaps in any of those areas--you can easily compromise care and outcomes quickly," he said.