The use of ‘telestroke’ is improving outcomes and survival chances for stroke patients, new research has concluded.
A newly-published study shows that people who receive stroke care at facilities that offer consultations via stroke telemedicine, known as telestroke, fare better than patients who get stroke care at places without such services.
The study is the first analysis of telestroke patient outcomes. It shows that those who get care at hospitals that offer telemedicine for stroke assessment receive superior care and are more likely to survive strokes than patients who went to similar hospitals without telestroke services.
Patients who go to the hospital with symptoms suggestive of a stroke need rapid expert assessment and treatment to halt brain damage, which could mean the difference between life and death.
Yet many hospitals do not have round-the-clock stroke care teams.
To make up for this deficiency, many hospitals, particularly in the United States, offer telemedicine consultations with stroke specialists who may be located hundreds of miles away.
And this, according to researchers in the Blavatnik Institute at Harvard Medical School, can vastly improve outcomes for patients.
The telestroke services evaluated in the study allow hospitals without local expertise in treating stroke to connect patients to neurologists who specialise in treating stroke.
Using video, off-site experts can virtually examine an individual with symptoms suggestive of stroke, review radiology tests, and make recommendations about the best course of treatment.
The use of remote stroke assessments is becoming more widespread. Telestroke is now in use in almost one third of hospitals in the United States, but evaluations of its impact across a broad range of hospitals has been limited.
“Our findings provide important evidence that telestroke improves care and can save lives,” says study senior author Ateev Mehrotra, associate professor of health care policy and of medicine at HMS.
For the study, the researchers compared outcomes and 30-day survival among 150,000 patients with stroke treated at more than 1,200 U.S. hospitals, half of which offered telestroke consults and half of which did not.
One outcome the study looked at was whether patients received reperfusion treatment, which restores blood flow to regions of the brain affected by the stroke before irreparable damage occurs.
Compared with patients who received care at non-telestroke hospitals, patients who received care at telestroke hospitals had relative rates of reperfusion treatment that were 13 per cent higher and relative rates of 30-day mortality that were four per cent lower.
The researchers saw the largest positive benefits at hospitals with the lowest patient volume and hospitals in rural areas.
“The benefits from telestroke appear to be the greatest at small rural hospitals—the very facilities that were also the least likely to have telestroke capacity,” says first author Andrew Wilcock, assistant professor at the University of Vermont Larner College of Medicine and a visiting fellow in health care policy at HMS.
“These findings emphasise the need to address the financial barriers these smaller hospitals face in introducing telestroke.”
