Telemedicine aids stroke patients
Patients who go to the hospital with symptoms suggestive of a stroke need rapid expert assessment and treatment to halt brain damage; it 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 U.S. hospitals offer telemedicine consults with stroke specialists who may be located hundreds of miles away.
A study by health policy researchers in the Blavatnik Institute at Harvard Medical School and colleagues shows that patients who receive stroke care at facilities with telemedicine consults for stroke assessment, known as telestroke, receive better care and are more likely to survive strokes than patients who go to similar hospitals without these services. The study represents the first national analysis of telestroke patient outcomes.
The telestroke services evaluated in this study allow hospitals without local expertise to connect patients to neurologists who specialize in treating stroke. Off-site experts can examine by video an individual with symptoms suggestive of stroke, review brain imaging or radiology tests, and make recommendations about the best course of treatment.
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 hospitals without telestroke, patients who received care at telestroke hospitals had 13 percent higher relative rates of reperfusion treatment and 4 percent lower relative rates of 30-day mortality. The researchers saw the largest benefits at smaller hospitals, at rural hospitals, and in patients 85 and older.
The researchers point out the benefits that telestroke would offer rural hospitals if it were made available, and if they had the budget for it, and note that the findings emphasize the need to address the financial barriers smaller hospitals face in introducing such services.
Wilcock A et al., JAMA Neurology, March 2021
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