Telestroke 10 years later - 'telestroke 2.0'

Jeffrey A Switzer, Steven R. Levine, David C Hess

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

Background: The lack of physicians with specialty stroke training represents a significant challenge to the future of stroke. This deficit limits both quality stroke care and clinical research initiatives. Methods: The use of telemedicine for stroke ('telestroke') has been an attempt to overcome this shortage and extend stroke expertise to locations which lack coverage. However, the initial telestroke systems required a point-to-point connection for transmission and only provided videoconferencing which limited their generalizability and usefulness. 'Telestroke 2.0' is the authors' vision of an integrative web-based telestroke system combining high-quality audiovideo transmission, the ability of consults and teleradiology to be carried out from any desktop or laptop computer with web-access, decision and technical support, creation of billable physician documentation and electronic medical record connectivity. Results: These features will facilitate the development of statewide and regional telestroke call networks with an opportunity for physician supply companies to fill in coverage gaps. In addition, telestroke 2.0 may improve acute stroke research by increasing trial efficiency via the addition of non-academic recruitment sites, enhancing trial validity by centralizing neurologic examinations via recorded encounters, and generalizing clinical trial results to community hospital settings. Conclusions: Greater diffusion and long-term sustainability of telestroke systems will be dependent upon improvements in patient and hospital reimbursement for acute stroke and telestroke care.

Original languageEnglish (US)
Pages (from-to)323-330
Number of pages8
JournalCerebrovascular Diseases
Volume28
Issue number4
DOIs
StatePublished - Sep 1 2009

Fingerprint

Stroke
Occupational Health Physicians
Teleradiology
Videoconferencing
Physicians
Telemedicine
Electronic Health Records
Quality of Health Care
Community Hospital
Neurologic Examination
Research
Documentation
Clinical Trials

Keywords

  • Acute stroke
  • Electronic medical record
  • Ischemic stroke
  • Recombinant tissue-plasminogen activator
  • Stroke training
  • Telestroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Telestroke 10 years later - 'telestroke 2.0'. / Switzer, Jeffrey A; Levine, Steven R.; Hess, David C.

In: Cerebrovascular Diseases, Vol. 28, No. 4, 01.09.2009, p. 323-330.

Research output: Contribution to journalReview article

@article{31c928fd9bb34fd3818719ba48fc80e8,
title = "Telestroke 10 years later - 'telestroke 2.0'",
abstract = "Background: The lack of physicians with specialty stroke training represents a significant challenge to the future of stroke. This deficit limits both quality stroke care and clinical research initiatives. Methods: The use of telemedicine for stroke ('telestroke') has been an attempt to overcome this shortage and extend stroke expertise to locations which lack coverage. However, the initial telestroke systems required a point-to-point connection for transmission and only provided videoconferencing which limited their generalizability and usefulness. 'Telestroke 2.0' is the authors' vision of an integrative web-based telestroke system combining high-quality audiovideo transmission, the ability of consults and teleradiology to be carried out from any desktop or laptop computer with web-access, decision and technical support, creation of billable physician documentation and electronic medical record connectivity. Results: These features will facilitate the development of statewide and regional telestroke call networks with an opportunity for physician supply companies to fill in coverage gaps. In addition, telestroke 2.0 may improve acute stroke research by increasing trial efficiency via the addition of non-academic recruitment sites, enhancing trial validity by centralizing neurologic examinations via recorded encounters, and generalizing clinical trial results to community hospital settings. Conclusions: Greater diffusion and long-term sustainability of telestroke systems will be dependent upon improvements in patient and hospital reimbursement for acute stroke and telestroke care.",
keywords = "Acute stroke, Electronic medical record, Ischemic stroke, Recombinant tissue-plasminogen activator, Stroke training, Telestroke",
author = "Switzer, {Jeffrey A} and Levine, {Steven R.} and Hess, {David C}",
year = "2009",
month = "9",
day = "1",
doi = "10.1159/000229550",
language = "English (US)",
volume = "28",
pages = "323--330",
journal = "Cerebrovascular Diseases",
issn = "1015-9770",
publisher = "S. Karger AG",
number = "4",

}

TY - JOUR

T1 - Telestroke 10 years later - 'telestroke 2.0'

AU - Switzer, Jeffrey A

AU - Levine, Steven R.

AU - Hess, David C

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Background: The lack of physicians with specialty stroke training represents a significant challenge to the future of stroke. This deficit limits both quality stroke care and clinical research initiatives. Methods: The use of telemedicine for stroke ('telestroke') has been an attempt to overcome this shortage and extend stroke expertise to locations which lack coverage. However, the initial telestroke systems required a point-to-point connection for transmission and only provided videoconferencing which limited their generalizability and usefulness. 'Telestroke 2.0' is the authors' vision of an integrative web-based telestroke system combining high-quality audiovideo transmission, the ability of consults and teleradiology to be carried out from any desktop or laptop computer with web-access, decision and technical support, creation of billable physician documentation and electronic medical record connectivity. Results: These features will facilitate the development of statewide and regional telestroke call networks with an opportunity for physician supply companies to fill in coverage gaps. In addition, telestroke 2.0 may improve acute stroke research by increasing trial efficiency via the addition of non-academic recruitment sites, enhancing trial validity by centralizing neurologic examinations via recorded encounters, and generalizing clinical trial results to community hospital settings. Conclusions: Greater diffusion and long-term sustainability of telestroke systems will be dependent upon improvements in patient and hospital reimbursement for acute stroke and telestroke care.

AB - Background: The lack of physicians with specialty stroke training represents a significant challenge to the future of stroke. This deficit limits both quality stroke care and clinical research initiatives. Methods: The use of telemedicine for stroke ('telestroke') has been an attempt to overcome this shortage and extend stroke expertise to locations which lack coverage. However, the initial telestroke systems required a point-to-point connection for transmission and only provided videoconferencing which limited their generalizability and usefulness. 'Telestroke 2.0' is the authors' vision of an integrative web-based telestroke system combining high-quality audiovideo transmission, the ability of consults and teleradiology to be carried out from any desktop or laptop computer with web-access, decision and technical support, creation of billable physician documentation and electronic medical record connectivity. Results: These features will facilitate the development of statewide and regional telestroke call networks with an opportunity for physician supply companies to fill in coverage gaps. In addition, telestroke 2.0 may improve acute stroke research by increasing trial efficiency via the addition of non-academic recruitment sites, enhancing trial validity by centralizing neurologic examinations via recorded encounters, and generalizing clinical trial results to community hospital settings. Conclusions: Greater diffusion and long-term sustainability of telestroke systems will be dependent upon improvements in patient and hospital reimbursement for acute stroke and telestroke care.

KW - Acute stroke

KW - Electronic medical record

KW - Ischemic stroke

KW - Recombinant tissue-plasminogen activator

KW - Stroke training

KW - Telestroke

UR - http://www.scopus.com/inward/record.url?scp=67651006537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67651006537&partnerID=8YFLogxK

U2 - 10.1159/000229550

DO - 10.1159/000229550

M3 - Review article

C2 - 19628933

AN - SCOPUS:67651006537

VL - 28

SP - 323

EP - 330

JO - Cerebrovascular Diseases

JF - Cerebrovascular Diseases

SN - 1015-9770

IS - 4

ER -