Abstract
BackgroundHealth care delivery for cerebrovascular diseases is a complex process, which may be improved using telestroke networks.ObjectiveThe purpose of this work was to establish and implement a protocol for the management of patients with acute stroke symptoms according to the available treatment alternatives at the initial point of care and the transfer possibilities.MethodsThe review board of our institutions approved this work. The protocol was based on the latest guidelines of the American Heart Association and American Stroke Association. Stroke care requires human and technological resources, which may differ according to the patient’s point of entry into the health care system. Three health care settings were identified to define the appropriate protocols: primary health care setting, intermediate health care setting, and advanced health care setting.ResultsA user-friendly web-based telestroke solution was developed. The predictors, scales, and scores implemented in this system allowed the assessment of the vascular insult severity and neurological status of the patient. The total number of possible pathways implemented was as follows: 10 in the primary health care setting, 39 in the intermediate health care setting, and 1162 in the advanced health care setting.ConclusionsThe developed comprehensive telestroke platform is the first stage in optimizing health care delivery for patients with stroke symptoms, regardless of the entry point into the emergency network, in both urban and rural regions. This system supports health care personnel by providing adequate inpatient stroke care and facilitating the prompt transfer of patients to a more appropriate health care setting if necessary, especially for patients with acute ischemic stroke within the therapeutic window who are candidates for reperfusion therapies, ultimately contributing to mitigating the mortality and morbidity associated with stroke.
Highlights
Stroke is a major source of disability and death in both developed and developing countries [1,2,3,4]
We have developed several strategies to improve the quality of care and speed up the transfer of patients with acute stroke symptoms from urban and rural areas to our hospital, a certified primary stroke center with thrombectomy capabilities
intravenous recombinant tissue plasminogen activator (IV rtPA) administration can be provided in the intermediate health care setting or advanced health care setting, while thrombectomy is performed only in the advanced health care setting
Summary
Stroke is a major source of disability and death in both developed and developing countries [1,2,3,4]. Conclusions: The developed comprehensive telestroke platform is the first stage in optimizing health care delivery for patients with stroke symptoms, regardless of the entry point into the emergency network, in both urban and rural regions. This system supports health care personnel by providing adequate inpatient stroke care and facilitating the prompt transfer of patients to a more appropriate health care setting if necessary, especially for patients with acute ischemic stroke within the therapeutic window who are candidates for reperfusion therapies, contributing to mitigating the mortality and morbidity associated with stroke
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