A study from the US Department of Veterans Affairs, Regenstrief Institute and Indiana University School of Medicine has shown that a telestroke programme prevented unnecessary hospital transfers for stroke patients.
The Veterans Health Administration (VHA) initiative makes expert stroke care quickly available to patients, even at rural facilities with limited staffing.
“This analysis suggests that telestroke provides additional benefits for both patients and health systems,” said senior author Linda Williams, a VA researcher and a Regenstrief research scientist in Indianapolis.
“It increases care efficiency and cost-effectiveness, while further optimising care for the patient who does not have to endure an unnecessary or even counterproductive transfer to another facility.”
The VHA programme provides acute stroke care at facilities that do not have a neurologist available.
Through a mobile device, a neurologist from the central hub is able to evaluate the patients and provide a treatment plan for the on-site staff to carry out.
Some patients can be treated at the community facility, while others need to be moved to a hospital with a higher level of care such as a comprehensive stroke care centre.
The neurologist from the central hub helps the on-site clinical team make that decision.
For this study, the researchers analysed the number of patient transfers at 21 VHA facilities before and after the implementation of the programme.
They found the likelihood of being transferred to another facility decreased by 60 percent after the its implementation.
The programme also increased the chance that the patient received timely acute stroke treatment (thrombosis).
“The VHA telestroke programme facilitates timely assessment of stroke and elevates the level of care at smaller facilities, eliminating the need for many transfers,” said Dr Williams.
“This demonstrates another strategy to leverage telehealth in acute care settings while also reducing rural healthcare disparities.”
‘Impact of Telestroke Implementation on Emergency Department Transfer Rate’ is available online ahead of print in Neurology.
This project was funded, in part, by the VA Office of Rural Health and the VA Health Services Research and Development Precision-Monitoring Quality Enhancement Research Initiative (QUERI).
