Abstract WP52: Evaluation of Post Stroke Telehealth Services in Texas (Vast-1)

Abstract

Background: Shortly after AHA/ASA released an updated policy on stroke care systems, COVID-19 disrupted these systems. Lockdowns and social distancing were considered critical to mitigate COVID-19 transmission but altered public perceptions about stroke medical care. As a result, telehealth expanded rapidly across Texas. However, little is known how to optimally integrate telehealth services into the continuum of stroke care. Methods: To identify barriers and facilitators of post-acute stroke telehealth services among stroke survivors’ facilities of the Lone Star Stroke Consortium (LSSC) Research Consortium, we conducted semi-structured interviews with stroke providers and focus groups with patients. Audiotapes were transcribed, and files prepared for analysis. Using a grounded theory approach, we performed data analysis to allow theory to emerge from data. Two independent reviewers read transcripts, developed coding using an iterative consensus building, verified codes, developed concepts, and created categories. Constant comparison process found emerging themes within each category. Results: We enrolled 23 providers and 34 patients. Access, telemedicine encounter and technology were revealed as major categories of post-acute stroke telehealth among providers and patients. Facilitators of access included increased accessibility and elimination of barriers. Reliable internet connection and technological skills were barriers for both groups. Patients and providers identified virtual visits as good. However, full medical exam, including cognitive evaluation, was a barrier for patients and providers. Technology increased ability to communicate with patients and providers. Barriers included constrains of internet services, lack of documentation for virtual visits, and lack of telemedicine platform. Conclusion: Our study will contribute to future telehealth services integration into continuum of stroke care.