Telestroke: Spearheading Telemedicine

Stroke is a condition where telemedicine has made a great impact in a short amount of time. It is frequently the case that a stroke patient is unable to be seen by a neurological specialist in the short, hours long window during which they are most responsive to treatment and physical therapy. Telemedicine closes this gap by putting nurses and patients in direct contact with specialized neurologists at a distance, allowing life altering care to be administered on demand. Stroke care is one of the most important demonstrations of the powers and capabilities of telemedicine.

As the leading cause of long-term disability and a leading cause of death in the United States, the human and economic cost of stroke is considerable. Efforts to mitigate the damage of stroke are undermined by lack of immediate access to neurologists, as timeliness is crucial to a better recovery prognosis. Telemedicine makes an impact by assuring that stroke patients at understaffed peripheral hospitals or clinics can receive care from the proper experts centralized in larger hospitals. One application of telemedicine in South Carolina found that doctors could remotely administer the life saving anti-coagulant tPA with much greater success than otherwise. Thanks to this successful implementation of telemedical infrastructure, 90% of South Carolina's stroke patients now have access to stroke care within the first hour of onset.

Telestroke is the fastest growing trend in stroke care and one of the most mainstream applications of telemedicine for good reason. It has even been called “the poster child of telemedicine” by Lee Schwaam of the Department of Neurology at Massachusetts General Hospital. A shortage of stroke specialists demands a technical solution since the time-sensitive nature of a stroke requires immediate care. Now both the shortage of specialists and the immediacy of the required medical attention can be collapsed together in the telemedical framework, which can put a neurologist (virtually) in front of a patient in little time. Collaboration between the distant neurologist and the onsite nurses ensures that there are no impediments to assessing the patient's condition.

A German study corroborates many of these findings. One of the key observations of their 10 year long examination of the effects of a telestroke program was that the time it took to administer important drugs fell from 80 minutes to 40 minutes. For a medical crisis event where every second counts, cutting the response time by half is a major achievement.

The fantastic success of telestroke suggests that other conditions that fit its general problem frame—shortage of specialists, time sensitive—will also be well adopted into the telemedical framework. The undeniable and significant improvements to stroke care thanks to telemedicine ensures the mainstreaming of the technology will be spearheaded by telestroke applications.

laurel christensen