Express improvement of acute stroke care accessibility in large regions using a centralized telestroke network

Abstract

Introduction: Acute ischemic stroke therapy has improved in recent decades, decreasing the rates of disability and death among stroke patients. Unfortunately, all health care systems have geographical disparities in infrastructure for stroke patients. A centralized telestroke network might be a low-cost strategy to reduce differences in terms of geographical barriers, equitable access, and quality monitoring across different hospitals. Aims: We aimed to quantify changes in stroke patients’ geographic access to specialized evaluation by neurologists and to intravenous acute stroke reperfusion treatments following the rapid implementation of a centralized telestroke network in the large region of Andalusia (8.5 million inhabitants). Methods: We conducted an observational study using spatial and analytical methods to examine how a centralized telestroke network influences the quality and accessibility of stroke care for a large region. Results: In the pre-implementation period, 5,005,477 (59.72% of the Andalusian population) had access to specialized stroke care in less than 30 min. After the 5-month process of implementing the telestroke network, 7,832,988 (93.5%) inhabitants had an access time of less than 30 min, bridging the gap in acute stroke care in rural hospitals. Conclusions: A centralized telestroke network may be an efficient tool to reduce the differences in stroke care access and quality monitoring across different hospitals, especially in large regions with low population density.

Impact of Direct Transport to Thrombectomy-Capable Center vs. Nearby/Distant Local Stroke Centers on Stroke Outcome in Patients Undergoing Thrombectomy: A Real-Life Study

“…The onset-to-needle time was similar between the groups, with neither model causing a delay in IVT. It is worth noting that our province implemented a telestroke network via video call in July 2019, providing distant specialized care to patients with a suspected ischemic stroke that were primarily assessed by regional hospitals [8]. Prior to this, the province had a telestroke system based on telephone calls to the on-call referring neurologist.…”

Direct Mechanical Thrombectomy vs. Bridging Therapy in Stroke Patients in A “Stroke Belt” Region of Southern Europe

“…Recently, the introduction of a centralized telestroke network has allowed this subgroup of patients to access this specialized care in less than 30 minutes. Despite this, transfer to the Thrombectomy Center continues to be required and a drip-and-ship model of organization predominates [ 45 ]. This is especially relevant given the greater benefit of IVT in this subgroup of patients [ 2 , 18 ].…”

Closing the Sex-Based Differences in Stroke Care: Insights from a Large Telestroke Network on Treatment and Postacute Management

“…Owing to the convenience of having the entire population’s medical records already centralized, network requirements are minimal, consisting mainly of a videoconferencing system (a smartphone with a 4G connection to each center and an on-call neurologist) to allow communication between professionals. 9 …”