A Web-based Telestroke System Facilitates Rapid Treatment of Acute Ischemic Stroke Patients in Rural Emergency Departments

Switzer, Jeffrey A.; Hall, Christiana E.; Gross, Hartmut; Waller, Jennifer L.; Nichols, Fenwick T.; Wang, Sam C.; Adams, Robert J.; Hess, David C.

doi:10.1016/j.jemermed.2007.06.041

Cited by 92 publications

(59 citation statements)

References 31 publications

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“…Because of nonmodifiable regional structures, the transfer of our concept to other rural regions meets limitations. The population density in the rural TEMPiS area of 127 inhabitants/km 2 19,20 Our single-network data represent prospectively collected registry data, routine data, and data of 1 health insurance. Therefore, selection and coding biases as well as data collection errors cannot be excluded.…”

Section: Discussionmentioning

confidence: 99%

TeleStroke Units Serving as a Model of Care in Rural Areas

Müller-Barna

Hubert

Boy

et al. 2014

Stroke

120

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Background and Purpose— Stroke Unit care improves stroke prognosis and is recommended for all patients with stroke. In rural areas, population-wide implementation of Stroke Units is challenging. Therefore, the TeleMedical Project for integrative Stroke Care (TEMPiS) was established in 2003 as a TeleStroke Unit network to overcome this barrier in Southeast Bavaria/Germany. Evaluation of its implementation between 2003 and 2005 had revealed improved process quality and clinical outcomes compared with matched hospitals without TeleStroke Units. Data on sustainability of these effects are lacking. Methods— Effects on the stroke care of the local population were analyzed by using data from official hospital reports. Prospective registries from 2003 to 2012 describe processes and outcomes of consecutive patients with stroke and transient ischemic attack treated in TEMPiS hospitals. Quality indicators assess diagnostics, treatment, and outcome. Rates and timeliness of intravenous thrombolysis as well as data on teleconsultations and secondary interhospital transfers were reported over time. Results— Within the covered area, network implementation increased the number of patients with stroke and transient ischemic attack treated in hospitals with (Tele-)Stroke Units substantially from 19% to 78%. Between February 2003 and December 2012, 54 804 strokes and transient ischemic attacks were treated in 15 regional hospitals, and 31 864 teleconsultations were performed. Intravenous thrombolysis was applied 3331 stroke cases with proportions increasing from 2.6% to 15.5% of all patients with ischemic stroke. Median onset-to-treatment times decreased from 150 (interquartile range, 127–163) to 120 minutes (interquartile range, 90–160) and door-to-needle times from 80 (interquartile range, 68–101) to 40 minutes (interquartile range, 29–59). Conclusions— TeleStroke Units can provide sustained high-quality stroke care in rural areas.

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Section: Discussionmentioning

confidence: 99%

TeleStroke Units Serving as a Model of Care in Rural Areas

Müller-Barna

Hubert

Boy

et al. 2014

Stroke

120

View full text Add to dashboard Cite

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“…Payment is on a fee-for-service basis and is the same as the reimbursement for covered evaluation and management services furnished in conventional, face-to-face consultations. 116 …”

Section: Operationsmentioning

confidence: 99%

Recommendations for the Implementation of Telemedicine Within Stroke Systems of Care

Schwamm¹,

Audebert²,

Amarenco³

et al. 2009

Stroke

274

146

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“…Advanced stroke telemedicine applications are unified in that they can deliver audiovisual, Picture Archiving and Communication Systems (PACS) imaging, and clinical notes within a single software program. 16,18,19 …”

Section: Introductionmentioning

confidence: 99%