Improving Telestroke Treatment Times in an Expanding Network of Hospitals.
Publication/Presentation Date
2-1-2016
Abstract
BACKGROUND: Like all medical innovations, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited resources is laudable but insufficient. An analysis of stroke treatment within a telemedicine network in 2013 showed that tissue-type plasminogen activator (tPA) could be safely and reliably administered within a practice-based model of telestroke care. Since then, hospital volume and tPA administration within this network have tripled. We hypothesize that a practice-based model of telestroke can maintain positive outcomes in the face of rapid growth.
METHODS: Data on tPA treatment times and outcomes after thrombolysis were gathered for 165 patients treated with alteplase between November 2012 and November 2014. Comparisons were made to a previous published study of 54 patients seen between October 2010 and October 2012 in the same network. Primary outcome measures were average door-to-needle (DTN) time for TPA administration and average call-to-needle (CTN) time.
RESULTS: Significant reductions were observed in median DTN (93 versus 75 minutes, P < .01) and median CTN (56 versus 41 minutes, P < .01). Quality outcome measures such as post-tPA symptomatic hemorrhage (2 [4%] versus 9 [5%], P = .23), length of stay (4 versus 4 days, P = .45), mortality (8 [15%] versus 16 [10%]; P = .32), and percentage of stroke patients treated remained stable.
CONCLUSIONS: This study shows that a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.
Volume
25
Issue
2
First Page
288
Last Page
291
ISSN
1532-8511
Published In/Presented At
Sanders, K. A., Patel, R., Kiely, J. M., Gwynn, M. W., & Johnston, L. H. (2016). Improving Telestroke Treatment Times in an Expanding Network of Hospitals. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 25(2), 288–291. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.030
Disciplines
Medicine and Health Sciences
PubMedID
26654667
Department(s)
Department of Medicine
Document Type
Article