Telestroke on Tap for Rural Locales

Stroke care improved with telestroke technology

(RxWiki News) For some small, rural hospitals, having an around-the-clock stroke expert on staff isn't cost effective as compared to the number of strokes treated. Instead a technological solution called telestroke may be more appropriate.

Using two way telemedicine that features both audio and video may be the best method to deliver stroke care for such medical facilities.

"When possible seek stroke treatment at a certified stroke care center."

Dr. Jennifer J. Majersik, a physician with the University of Utah School of Medicine, said that the findings are significant, especially considering the increasing costs of healthcare.  She said that if barriers to using telestroke such as low reimbursement rates and costly equipment are improved, telestroke has the potential to greatly reduce the disparity in stroke care for patients at rural hospitals.

Researchers reviewed existing data from previous telestroke studies and records from large multi-hospital telestroke network databases at the University of Utah hospitals and clinics in Salt Lake City and the Mayo Clinic in Phoenix.

Investigators calculated the cost effectiveness of telestroke by comparing costs and quality-adjusted life years of stroke patients who were treated through telestroke. They also scrutinized stroke patients who received care at a rural emergency department without telestroke or the expertise of a stroke expert. Quality-adjusted life years were calculated by measuring the disease burden and adding years of life by using telestroke.

Researchers discovered that the cost of telestroke over the lifetime of a patient was less than $2,500 per quality-adjusted life year. The usual cost cutoff to determine stroke care cost effectiveness is $50,000 per quality-adjusted life year.

Dr. Majersik also said that using telestroke likely could aid in ensuring that a higher percentage of patients receive clot-busting drugs. The drugs can significantly reduce death and stroke disability if patients receive them within the first four and a half hours after stroke symptoms appear.

Though clot busters are known to be helpful, only between 2 percent and 4 percent of patients receive them, with the lower percentage occurring in stroke patients who receive treatment in rural hospitals because few doctors have experience using clot-busting drugs.

The review study was published in the Sept. 14 issue of Neurology, the medical journal of the American Academy of Neurology.

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Review Date: 
September 16, 2011