Telestroke units - a way for hospitals to connect with stroke experts through telecommunications - improve stroke care for patients who reside in areas lacking extensive neurology support, according to researchers.
The research team, who reached their findings by conducting a 10-year review of telestroke units in Bavaria, Germany, recently published their findings in the journal Stroke.
Telestroke is a form of telemedicine specifically aimed at providing care for stroke patients who reside in areas where stroke expertise is lacking. It involves electronically connecting hospitals without extensive neurology support to centers that do offer such support.
In 2003, 12 regional hospitals in Bavaria that were deprived of neurology and neurosurgery units received a telestroke unit.
These units meant that through telecommunications, these hospitals could connect to an array of neurological experts at two neurological stroke centers 24 hours a day. Three more telestroke units were introduced into hospitals in Bavaria by 2012.
Between 2003 and 2012, all 15 units had provided 31,864 patient consultations. The percentage of stroke and mini-stroke patients treated in hospitals with the telestroke units soared during this time, from 19% to 78%.
But what impact have these units had on patient care? Lead study author Dr. Peter Müller-Barna, of the department of neurology at the Agatharied Hospital in Hausham, Germany, and his team investigated.
Telestroke units improved tPA administration for stroke patients
They found that the percentage of patients among the 15 regional hospitals who received tissue plasminogen activator (tPA) - a drug administered to patients who experience ischemic stroke to break down blood clots - increased from 2.6% in 2003 to 15.5% in 2012.
The average time between patients' arrival at the hospital and administering of tPA declined from 80 minutes to 40 minutes, which the team notes surpasses the target set by the American Heart Association/American Stroke Association of treating a minimum of 50% of patients within 1 hour.
Furthermore, the average time between onset of stroke and administration of tPA reduced from 150 minutes to 120 minutes.
Commenting on the findings, Dr. Müller-Barna says:
"Co-operation within medical networks can be a huge benefit for patients. Telemedicine is a wonderful option to support the close co-operation of physicians from regional hospitals and tertiary stroke centers."
In addition, the team found that the percentage of patients transferred from regional hospitals to stroke centers declined between 2003 and 2012, from 11.5% to 7%.
"Telemedicine can accelerate the emergency transfer of patients in need of neurosurgery. At the same time, it helps avoid unnecessary transfers because expert vascular neurologists are involved in remote patient assessment by video examination and the interpretation of CT scans," says Dr. Müller-Barna.
Although this study assesses the use of telestroke units in Germany, the researchers say their findings could apply to any region of the US that lacks access to a stroke unit or stroke experts.
Dr. Müller-Barna notes that the increase in the percentage of stroke patients treated in hospitals with the telestroke units indicates there is "growing acceptance" of them, which is promising.
But he adds that the goal is to reach nearer 100%, and setting up more telestroke units in areas that lack stroke centers should help reach this target.
Medical News Today recently reported on a study revealing that hospitalizations and deaths from stroke and heart disease fell in the last decade.