Telestroke program increases access to stroke care by 40 percent

Telestroke programs substantially improve access to life-saving stroke care, extending coverage to less populated areas in an effort to reduce disparities in stroke care access. A new study by researchers from the Perelman School of Medicine at the University of Pennsylvania, being presented at the American Academy of Neurology's 65th Annual Meeting in San Diego March 16-23, 2013, found that telemedicine programs in Oregon pushed stroke coverage into previously uncovered, less populated areas and expanded coverage by approximately 40 percent.

"Telestroke programs can reach patients in smaller communities and provide time-critical treatment to previously unreached people," said senior study author Brendan Carr, MD, MA, Assistant Professor of , Surgery, & Epidemiology in the Perelman School of Medicine at the University of Pennsylvania. "Increasing telestroke networks gives everyone a better chance of surviving a , the fourth leading cause of death in the United States."

Previous research by Dr. Carr and colleagues found that only 54.5 percent of Oregon residents could reach a stroke center by ground within 60 minutes. The new study shows that, by employing telemedical systems in concert with in-person care, nearly 80 percent of residents had access to expert stroke care within one hour.

The study evaluated all hospitals in Oregon, finding that 43 percent of the population could reach a stroke center in person within 60 minutes, 76 percent had telemedical access, 40 percent had access to both, and 20 percent had no access to stroke care within an hour.

Researchers noted that in-person stroke care was clustered in urban areas, and while telestroke care was also available in urban centers, it also reached less populated areas with low rates of uninsured.

Penn Medicine extends to patients throughout the region through the Penn NeuroRescue program, using telemedicine systems to bring expert consultations 24/7 to hospitals in distant locales (e.g. the Jersey Shore) and transferring those who need surgery and/or specialized neurointensive critical care to the Hospital of the University of Pennsylvania (HUP), the Philadelphia region's first and only Joint Commission-certified Comprehensive Stroke Center.

The Penn Medicine Neuroscience Center's team of neurovascular experts – from Neurology, Radiology, Neurosurgery, Vascular Surgery, Emergency Medicine and Nursing – provides quality, evidence-based care at the right level and right time, through remote diagnosis via telemedicine, onsite treatment provided at affiliated primary stroke centers, and with advanced neurosurgical or neuroradiological interventions and clinical research available at the Hospital of the University of Pennsylvania.

HUP's stroke center was founded in 1994 and was originally designated as a Primary Stroke Center by the Joint Commission in 2004. In addition to the newly-achieved advanced Comprehensive Stroke Certification at HUP, Penn Medicine's other hospitals – Pennsylvania Hospital and Penn Presbyterian Medical Center – received Primary Stroke Center certifications from The Joint Commission in the summer of 2012. This mix of Centers and the advanced Comprehensive Stroke Center at HUP allows Penn to address the needs of this complex population in the Delaware Valley and throughout the region.

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