The acute telestroke model of care in Australia: a potential roadmap for other emergency medical services?

García-Esperón, Carlos; Bladin, Chris; Kleinig, Timothy; Brown, Helen; Majersik, Jennifer J.; Wesseldine, Andrew; Butcher, Kenneth

doi:10.5694/mja2.51519

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…To address variability in stroke care in rural settings, telestroke networks have been developed in Australia [10,11] and worldwide [12,13], where rural spoke hospitals are supported by comprehensive centers. Locally, in New South Wales (NSW) in Australia, we first initiated a telestroke network in 2013 with a single rural hospital, which expanded over subsequent years to include 5 rural sites linked to a single comprehensive stroke center.…”

Section: Background and Rationalementioning

confidence: 99%

“…Telestroke services improve the rates of reperfusion treatment and functional patient outcomes without increasing the rates of treatment-induced hemorrhage, although it has been noted that evidence for impacts on resource use and cost-effectiveness is limited [50,51]. As a result, patients treated through telestroke networks achieve outcomes that are similar to those managed at comprehensive stroke centers [10,12,13]. Of note, in Australia, the importance of telehealth-supported stroke care was recently recognized through its inclusion in the Australia Stroke Foundation guidelines as best practice to improve outcomes in rural settings [52].…”

Section: Comparison With Prior Workmentioning

confidence: 99%

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TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study

Maltby,

Garcia-Esperon,

Jackson

et al. 2023

JMIR Serious Games

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Background Stroke management in rural areas is more variable and there is less access to reperfusion therapies, when compared with metropolitan areas. Delays in treatment contribute to worse patient outcomes. To improve stroke management in rural areas, health districts are implementing telestroke networks. The New South Wales Telestroke Service provides neurologist-led telehealth to 23 rural spoke hospitals aiming to improve treatment delivery and patient outcomes. The training of clinical staff was identified as a critical aspect for the successful implementation of this service. Virtual reality (VR) training has not previously been used in this context. Objective We sought to develop an evidence-based VR training module specifically tailored for stroke telehealth. During implementation, we aimed to assess the feasibility of workplace deployment and collected feedback from spoke hospital staff involved in stroke management on training acceptability and usability as well as perceived training impact. Methods The TACTICS VR Stroke Telehealth application was developed with subject matter experts. During implementation, both quantitative and qualitative data were documented, including VR use and survey feedback. VR hardware was deployed to 23 rural hospitals, and use data were captured via automated Wi-Fi transfer. At 7 hospitals in a single local health district, staff using TACTICS VR were invited to complete surveys before and after training. Results TACTICS VR Stroke Telehealth was deployed to rural New South Wales hospitals starting on April 14, 2021. Through August 20, 2023, a total of 177 VR sessions were completed. Survey respondents (n=20) indicated a high level of acceptability, usability, and perceived training impact (eg, accuracy and knowledge transfer; mean scores 3.8-4.4; 5=strongly agree). Furthermore, respondents agreed that TACTICS VR increased confidence (13/18, 72%), improved understanding (16/18, 89%), and improved awareness (17/18, 94%) regarding stroke telehealth. A comparison of matched pre- and posttraining responses revealed that training improved the understanding of telehealth workflow practices (after training: mean 4.2, SD 0.6; before training: mean 3.2, SD 0.9; P<.001), knowledge on accessing stroke telehealth (mean 4.1, SD 0.6 vs mean 3.1, SD 1.0; P=.001), the awareness of stroke telehealth (mean 4.1, SD 0.6 vs mean 3.4, SD 0.9; P=.03), ability to optimally communicate with colleagues (mean 4.2, SD 0.6 vs mean 3.7, SD 0.9; P=.02), and ability to make improvements (mean 4.0, SD 0.6 vs mean 3.5, SD 0.9; P=.03). Remote training and deployment were feasible, and limited issues were identified, although uptake varied widely (0-66 sessions/site). Conclusions TACTICS VR Stroke Telehealth is a new VR application specifically tailored for stroke telehealth workflow training at spoke hospitals. Training was considered acceptable, usable, and useful and had positive perceived training impacts in a real-world clinical implementation context. Additional work is required to optimize training uptake and integrate training into existing education pathways.

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Section: Background and Rationalementioning

confidence: 99%

Section: Comparison With Prior Workmentioning

confidence: 99%

TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study

Maltby,

Garcia-Esperon,

Jackson

et al. 2023

JMIR Serious Games

View full text Add to dashboard Cite

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Clinician Understanding, Acceptance and utilization of Ketogenic diet therapy for epilepsy in Australia and New Zealand: An online survey

Farrar,

D’Silva,

Cardamone

et al. 2024

Epilepsy & Behavior Reports

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Review article: Telehealth in Emergency Medicine in Australasia: Advantages and barriers

Leonny,

Bowra,

Davis

et al. 2024

Emerg Medicine Australasia

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The COVID‐19 pandemic catapulted Telehealth to the forefront of Emergency Medicine (EM) as an alternative way of assessing and managing patients. This challenged the traditional idea that EM can only be practised within brick‐and‐mortar EDs. Many Emergency Physicians may find the idea of practising Telehealth in Emergency Medicine (TEM) confronting, particularly in the absence of training and clear practice guidelines. The purpose of the present paper is to describe the current use of TEM in Australasia, and outline the advantages and barriers in adopting this practice domain.

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The acute telestroke model of care in Australia: a potential roadmap for other emergency medical services?

Cited by 6 publications

References 8 publications

TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study

TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study

Clinician Understanding, Acceptance and utilization of Ketogenic diet therapy for epilepsy in Australia and New Zealand: An online survey

Review article: Telehealth in Emergency Medicine in Australasia: Advantages and barriers

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