Stroke telemedicine

Bart M Demaerschalk, Madeline L Miley, Terri-Ellen J Kiernan, Bentley J Bobrow, Doren A Corday, Kay E Wellik, Maria I Aguilar, Timothy J Ingall, David W Dodick, Karina Brazdys, Tiffany C Koch, Michael P Ward, Phillip C Richemont, STARR Coinvestigators, Maria I Aguilar, Bentley J Bobrow, Bart M Demaerschalk, David W Dodick, Timothy J Ingall, Terri-Ellen J Kiernan, Byron R Spencer, Jeremy Barnes, Michelle Butler, Chad Carman, Robert Esposito, Elizabeth McMurtry, Brian E Scott, Michael E Sheehy, Sean Vitale, Michael P Ward, Kathern L Auer, Bryant Boyack, Aaron Bradbury, Mark Brecheisen, David Buckwalter, Michael Chipman, Marianna Coggins, David Dyer, Mary Katherine Harper, Akbar Khalid, Jorge Martinez, McMurtry McMurtry, Shem Rode, Sarah Sheperd, Travis Washut, Mara Windsor, Natalie Zaharoff, Andrew S Brenner, Dewane K Brueske, John B Carson, David Cushner, Matthew Dickson, David S Dowhan, Renee C Greven-Garcia, David E Haynes, Joan L Kelchner, John D Lewis, Phillip C Richemont, Bart M Demaerschalk, Madeline L Miley, Terri-Ellen J Kiernan, Bentley J Bobrow, Doren A Corday, Kay E Wellik, Maria I Aguilar, Timothy J Ingall, David W Dodick, Karina Brazdys, Tiffany C Koch, Michael P Ward, Phillip C Richemont, STARR Coinvestigators, Maria I Aguilar, Bentley J Bobrow, Bart M Demaerschalk, David W Dodick, Timothy J Ingall, Terri-Ellen J Kiernan, Byron R Spencer, Jeremy Barnes, Michelle Butler, Chad Carman, Robert Esposito, Elizabeth McMurtry, Brian E Scott, Michael E Sheehy, Sean Vitale, Michael P Ward, Kathern L Auer, Bryant Boyack, Aaron Bradbury, Mark Brecheisen, David Buckwalter, Michael Chipman, Marianna Coggins, David Dyer, Mary Katherine Harper, Akbar Khalid, Jorge Martinez, McMurtry McMurtry, Shem Rode, Sarah Sheperd, Travis Washut, Mara Windsor, Natalie Zaharoff, Andrew S Brenner, Dewane K Brueske, John B Carson, David Cushner, Matthew Dickson, David S Dowhan, Renee C Greven-Garcia, David E Haynes, Joan L Kelchner, John D Lewis, Phillip C Richemont

Abstract

Stroke telemedicine is a consultative modality that facilitates care of patients with acute stroke at underserviced hospitals by specialists at stroke centers. The design and implementation of a hub-and-spoke telestroke network are complex. This review describes the technology that makes stroke telemedicine possible, the members that should be included in a telestroke team, the hub-and-spoke characteristics of a telestroke network, and the format of a typical consultation. Common obstacles to the practice of telestroke medicine are explored, such as medicolegal, economic, and market issues. An example of a state-based telestroke network is thoroughly described, and established international telestroke networks are presented and compared. The opportunities for future advances in telestroke practice, research, and education are considered.

Trial registration: ClinicalTrials.gov NCT00623350.

Figures

FIGURE 1.
FIGURE 1.
A spoke hospital emergency physician at a mock patient's bedside is assisting the hub hospital stroke neurologist with the examination.
FIGURE 2.
FIGURE 2.
A hub hospital stroke neurologist and research coordinator are conducting a 2-way audiovisual telestroke consultation with the spoke hospital.
FIGURE 3.
FIGURE 3.
The BF Technologies (San Diego, CA) Stroke Team Remote Evaluation Using a Digital Observation Camera used for the Stroke Telemedicine for Arizona Rural Residents study.
FIGURE 4.
FIGURE 4.
The Stroke Telemedicine for Arizona Rural Residents network map outlining hub and spoke (current and potential) hospitals.
FIGURE 5.
FIGURE 5.
Map of current North American and European telestroke networks. REACH = Remote Evaluation of Acute Ischemic Stroke; RUN-Stroke = Emergency Neurology Network-Stroke; STARR = Stroke Telemedicine for Arizona Rural Residents; STENO = Stroke Network of University of Erlangen; STRokE DOC = Stroke Team Remote Evaluation Using a Digital Observation Camera; TEMPiS = Telemedic Project for Integrative Stroke Care; TESS = Telemedicine in Stroke in Swabia.

Source: PubMed

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