Why Use Telestroke? Information for Health Care Professionals
Stroke Morbidity and Mortality
A staggering number of people are affected by stroke in the United States, making it the #1 cause of disability and the #4 cause of death. Accordingly, the economic burden weighs heavily on health care, with costs for stroke care exceeding $100 billion annually and projections that this cost will double by the year 2030.1
This highlights the importance of collaboration to expedite treatment, reduce cost, and improve quality of care for stroke patients.
Time is Critical: Early Evaluation and Diagnosis Necessary
Time is critical in delivering effective acute stroke therapy. The greatest benefit with clot-busting medications such as intravenous tissue plasminogen activator (IV tPA) is when the medication is delivered within the first 90 minutes.2
Early evaluation and diagnosis is essential to achieving fast delivery of optimal stroke care.
Achieving Higher Rates of IV tPA Administration
Despite a long-standing awareness that IV tPA improves outcomes for ischemic stroke patients, administration rates remain low. Only approximately 3% to 8.5% of stroke victims in the United States receive IV tPA.3
National societies and guideline recommendations advocate for increased use of tPA in appropriate patients, however barriers remain high. Innovative solutions are needed to close the gap and achieve higher rates of IV tPA administration.
Froedtert & the Medical College of Wisconsin Telestroke Program
- 24/7 access to a Vascular Neurologist
- The only certified comprehensive stroke center in eastern Wisconsin and one of only two in the state.
- The only academic medical center in southeastern Wisconsin
- The largest team of neurovascular specialists in the region
- The highest enrolling center in stroke clinical trials in the region
Overcome Barriers Through Telestroke
The telestroke program uses evidence-based practice measures, delivering the highest quality care to stroke patients. Partner hospitals can overcome the barriers to delivering evidence-based comprehensive neurovascular care through telestroke practices.
- More accurate decision making than phone consultation alone, high rates of thrombolysis administration, low rates of intra-cerebral hemorrhage.4
- Increased rate of thrombolytic use in remote hospitals after implementation of a telestroke network.5
- Compared to no telestroke network, a telestroke system can result in more use of tPA and stroke therapies, more patients discharged home independently, and overall cost-savings for the network of hospitals.6
- Regional expansion of endovascular therapy for select patients. Thrombolysis with IV tPA remains the cornerstone of acute ischemic stroke treatment, however exclusion criteria remain considerable obstacles, including a short time window, a patient’s use of contraindicated medications, and recent surgery or other risks of bleeding. In appropriately selected patients, endovascular therapy offers an evidence-based American Heart Association / American Stroke Association Class 1 Level of evidence B recommendation for revascularization.7
- A collaborative network for acute stroke care using ongoing data collection and review can lead to significant improvements in care and increase compliance with performance metrics.8
- Telestroke networks can contribute to advancing science by improving recruitment into stroke clinical trials.9
- Heidenreich PA, et al. Circulation. 2012; 123:933-44. Circulation. 2012; 125:e2-e220.
- Hacke W et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363:768-774.
- Reeves MJ, Stroke 2005;36:1232-1240.
- Meyer BC et al. Lancet Neurol 2008;7:787-95.
- Amorim et al. JSCVD. 2013.
- Switzer JA et al. Circulation. 2013;6:18-26.
- Guidelines for the early management of patients with acute ischemic stroke. Stroke 2013;44:870-947.
- Stoeckle-Roberts S. et al. Joint Commission J Quality Patient Safety. 2006 (32):9;517-527.
- Switzer JA et al. Stroke 2010;41:566-569.