Abstract
Background: Tele-stroke has been an efficient cost-effective way to standardize care and improve access to immediate neurologic care for rural hospitals and other areas underserved by neurologists. Virtual telestroke support is commonly used in the Emergency Department. Hands-free wearable technology allows for seamless communication and faster more informed decisions. It can advance the triage of stroke patients into the pre-hospital setting at the scene or in the ambulance and facilitate the routing of patients to comprehensive stroke centers. Objective: To assess the feasibility and reliability of Xpert Eye TM solution, a Google Glass- based wearable solution in evaluating patients with suspected acute stroke. Methods: Consecutive patients with suspected stroke were evaluated concurrently by an on-site neurologist wearing Xpert Eye TM solution and a remotely located neurologist through Xpert Eye TM platform. Inter-rater reliability in calculating the NIH Stroke Scale (NIHSS) scores was evaluated. Results: Seventeen patients were included. There was a high degree of correlation in total NIHSS score (ICC 0.99 and weighted kappa 0.88) and across all NIHSS sub-items (ICC 0.81-1 and weighted kappa 0.68-1) between the two examiners. The maximum difference between the two NIHSS scores was 3. Conclusion: The use of Xpert Eye TM solution in tele-stroke is feasible and reliable. Using wearable solutions in tele-stroke can advance the care faster to the pre-hospital setting, at the scene or in the ambulance and can potentially facilitate triaging patients to appropriate stroke centers in the community.
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