Telestroke—the promise and the challenge. Part two—expansion and horizons

Abstract

Acute ischemic stroke remains a major public health concern, with low national treatment rates for the condition, demonstrating a disconnection between the evidence of treatment benefit and delivery of this treatment. Intravenous thrombolysis and endovascular thrombectomy are both strongly evidence supported and exquisitely time sensitive therapies. The mismatch between the distribution and incidence of stroke presentations and the availability of specialist care significantly affects access to care. Telestroke, the use of telemedicine for stroke, aims to surmount this hurdle by distributing stroke expertise more effectively, through video consultation with and examination of patients in locations removed from specialist care. This is the second of a two part review, and is focused on the challenges telestroke faces for wider adoption. It further details the anticipated evolution of this novel therapeutic platform, and the potential roles it holds in stroke prevention, ambulance based care, rehabilitation, and research.

Multidisciplinary amyotrophic lateral sclerosis telemedicine care: The store and forward method

“…Telemedicine as an accepted method of care delivery is expanding rapidly. The most extensive use of telemedicine in neurology has been for acute stroke care . Remote evaluation of patients in outlying hospitals using telemedicine has been shown to be safe and effective.…”

Electronic Alberta Stroke Program Early CT score change and functional outcome in a drip-and-ship stroke service

“…Inclusion of referring hospitals at different service levels enhanced the generalizability of the results. Increasing use of telestroke concepts might enhance the preselection of patients to avoid futile transfers 24 25…”

Telerehabilitation for Stroke Survivors: Systematic Review and Meta-Analysis (Preprint)

“…Unfortunately, there are several barriers that limit the spreading of telerehabilitation. These barriers include administrative licensing, medicolegal ambiguity, and financial sustainability [26].…”