Robotic telepresence versus standardly supervised stroke alert team assessments

Cumara B. O'Carroll, Joseph G. Hentz, Maria I. Aguilar, Bart M Demaerschalk

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center.

MATERIALS AND METHODS: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessments at a primary stroke center emergency department from 2009 to 2012. The primary outcome measure was the duration of assessment from stroke alert activation to treatment or downgrade.

RESULTS: The sample size was 196 subjects. The mean duration of time from stroke alert activation to initiation of intravenous (IV) thrombolytic treatment or downgrade was 8.6 min longer in the robotic group than in the standard group (p=0.03). Among the subgroup of acute ischemic stroke patients treated with IV thrombolysis, the mean duration of time from activation to treatment was 18 min longer in the robotic group than in the standard group (p=0.01). Safety outcomes including thrombolysis protocol violations (0% versus 1%), post-thrombolysis symptomatic intracranial hemorrhagic complications (3% versus 1%), and death during hospitalization (8% versus 6%) were low in the robotic group and not significantly different from that in the standard group.

CONCLUSIONS: Standard VN-supervised acute stroke team assessments were swifter than those supervised by robotic telepresence. Safety outcomes of robotic telepresence-supervised stroke alerts were excellent, and this modality may be preferred in circumstances when a VN is not immediately available on-site.

Original languageEnglish (US)
Pages (from-to)151-156
Number of pages6
JournalTelemedicine journal and e-health : the official journal of the American Telemedicine Association
Volume21
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Robotics
Stroke
Blood Vessels
Safety
Geography
Telemedicine
Emergency Medical Services
Sample Size
Hospital Emergency Service
Hospitalization
Therapeutics
Outcome Assessment (Health Care)
Databases

Keywords

  • remote consultation
  • stroke
  • stroke management
  • telemedicine
  • telestroke
  • thrombolytic therapy
  • tissue plasminogen activator

ASJC Scopus subject areas

  • Medicine(all)
  • Health Informatics
  • Health Information Management

Cite this

Robotic telepresence versus standardly supervised stroke alert team assessments. / O'Carroll, Cumara B.; Hentz, Joseph G.; Aguilar, Maria I.; Demaerschalk, Bart M.

In: Telemedicine journal and e-health : the official journal of the American Telemedicine Association, Vol. 21, No. 3, 01.03.2015, p. 151-156.

Research output: Contribution to journalArticle

@article{4bbd9c5104dc40048b256eb0b938df3e,
title = "Robotic telepresence versus standardly supervised stroke alert team assessments",
abstract = "BACKGROUND: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center.MATERIALS AND METHODS: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessments at a primary stroke center emergency department from 2009 to 2012. The primary outcome measure was the duration of assessment from stroke alert activation to treatment or downgrade.RESULTS: The sample size was 196 subjects. The mean duration of time from stroke alert activation to initiation of intravenous (IV) thrombolytic treatment or downgrade was 8.6 min longer in the robotic group than in the standard group (p=0.03). Among the subgroup of acute ischemic stroke patients treated with IV thrombolysis, the mean duration of time from activation to treatment was 18 min longer in the robotic group than in the standard group (p=0.01). Safety outcomes including thrombolysis protocol violations (0{\%} versus 1{\%}), post-thrombolysis symptomatic intracranial hemorrhagic complications (3{\%} versus 1{\%}), and death during hospitalization (8{\%} versus 6{\%}) were low in the robotic group and not significantly different from that in the standard group.CONCLUSIONS: Standard VN-supervised acute stroke team assessments were swifter than those supervised by robotic telepresence. Safety outcomes of robotic telepresence-supervised stroke alerts were excellent, and this modality may be preferred in circumstances when a VN is not immediately available on-site.",
keywords = "remote consultation, stroke, stroke management, telemedicine, telestroke, thrombolytic therapy, tissue plasminogen activator",
author = "O'Carroll, {Cumara B.} and Hentz, {Joseph G.} and Aguilar, {Maria I.} and Demaerschalk, {Bart M}",
year = "2015",
month = "3",
day = "1",
doi = "10.1089/tmj.2014.0064",
language = "English (US)",
volume = "21",
pages = "151--156",
journal = "Telemedicine Journal and e-Health",
issn = "1530-5627",
publisher = "Mary Ann Liebert Inc.",
number = "3",

}

TY - JOUR

T1 - Robotic telepresence versus standardly supervised stroke alert team assessments

AU - O'Carroll, Cumara B.

AU - Hentz, Joseph G.

AU - Aguilar, Maria I.

AU - Demaerschalk, Bart M

PY - 2015/3/1

Y1 - 2015/3/1

N2 - BACKGROUND: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center.MATERIALS AND METHODS: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessments at a primary stroke center emergency department from 2009 to 2012. The primary outcome measure was the duration of assessment from stroke alert activation to treatment or downgrade.RESULTS: The sample size was 196 subjects. The mean duration of time from stroke alert activation to initiation of intravenous (IV) thrombolytic treatment or downgrade was 8.6 min longer in the robotic group than in the standard group (p=0.03). Among the subgroup of acute ischemic stroke patients treated with IV thrombolysis, the mean duration of time from activation to treatment was 18 min longer in the robotic group than in the standard group (p=0.01). Safety outcomes including thrombolysis protocol violations (0% versus 1%), post-thrombolysis symptomatic intracranial hemorrhagic complications (3% versus 1%), and death during hospitalization (8% versus 6%) were low in the robotic group and not significantly different from that in the standard group.CONCLUSIONS: Standard VN-supervised acute stroke team assessments were swifter than those supervised by robotic telepresence. Safety outcomes of robotic telepresence-supervised stroke alerts were excellent, and this modality may be preferred in circumstances when a VN is not immediately available on-site.

AB - BACKGROUND: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center.MATERIALS AND METHODS: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessments at a primary stroke center emergency department from 2009 to 2012. The primary outcome measure was the duration of assessment from stroke alert activation to treatment or downgrade.RESULTS: The sample size was 196 subjects. The mean duration of time from stroke alert activation to initiation of intravenous (IV) thrombolytic treatment or downgrade was 8.6 min longer in the robotic group than in the standard group (p=0.03). Among the subgroup of acute ischemic stroke patients treated with IV thrombolysis, the mean duration of time from activation to treatment was 18 min longer in the robotic group than in the standard group (p=0.01). Safety outcomes including thrombolysis protocol violations (0% versus 1%), post-thrombolysis symptomatic intracranial hemorrhagic complications (3% versus 1%), and death during hospitalization (8% versus 6%) were low in the robotic group and not significantly different from that in the standard group.CONCLUSIONS: Standard VN-supervised acute stroke team assessments were swifter than those supervised by robotic telepresence. Safety outcomes of robotic telepresence-supervised stroke alerts were excellent, and this modality may be preferred in circumstances when a VN is not immediately available on-site.

KW - remote consultation

KW - stroke

KW - stroke management

KW - telemedicine

KW - telestroke

KW - thrombolytic therapy

KW - tissue plasminogen activator

UR - http://www.scopus.com/inward/record.url?scp=85016650454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016650454&partnerID=8YFLogxK

U2 - 10.1089/tmj.2014.0064

DO - 10.1089/tmj.2014.0064

M3 - Article

C2 - 25490742

AN - SCOPUS:84924806484

VL - 21

SP - 151

EP - 156

JO - Telemedicine Journal and e-Health

JF - Telemedicine Journal and e-Health

SN - 1530-5627

IS - 3

ER -