The use of telemedicine in the management of acute stroke.
No Thumbnail Available
Date
2014-01-01
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
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