The use of telemedicine in the management of acute stroke

Mark N. Rubin, Bart M. Demaerschalk

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Cerebrovascular disease, including acute ischemic stroke, remains a major public health problem in the US and throughout the world. There has been a concerted effort to apply evidence-based practices to stroke care to improve primary and secondary prevention as well as poststroke outcomes. Geography and workforce shortages contribute to a disparity in stroke care, however, among the substantial proportion of the US population that lives outside the reach of an acute stroke-ready hospital or a primary or comprehensive stroke center. In an attempt to combat the rural-to-urban disparity and expand the availability of best stroke practices, Levine and Gorman proposed the development of telemedical outreach for acute stroke evaluation and management, which they called "telestroke." Since then, the practice of telestroke has been found to have a high interrater agreement with a bedside assessment of the National Institutes of Health Stroke Scale score, to enhance correct thrombolysis decision making as compared with telephone-only consultation, and to be cost-effective. In light of these findings and the perception of benefit by acute stroke providers and patients, there has been growing interest in and a rapid expansion of telestroke networks in the US and internationally. There are legal and financial barriers to more widespread use of telemedicine in general, including telestroke. Further research is needed to understand the potential merits of telestroke infrastructure for the many phases of stroke care including poststroke hospitalization, prevention of complications, enhancing secondary prevention, and education of patients and providers.

Original languageEnglish (US)
Article numberE4
JournalNeurosurgical focus
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Endovascular
  • Stroke
  • Telecommunication
  • Telemedicine
  • Telestroke
  • Thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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