Telemedicine Can Save Lives and Reduce Disability

Photo: Fiber optic cable

Communication via internet can
save lives and prevent
disabilities in the treatment
of strokes;©
Gunnar Pippel

Telestroke is a two-way audiovisual linkup between neurologists in stroke centers and emergency rooms in underserved and rural areas. While repeated research has shown that telestroke enables quality stroke care in these underserved areas, only few stroke patients are benefitting from this lifesaving service. Doctor Mark Bisby was commissioned by the Canadian Stroke Network to study services across the country. To him, “the case for telestroke is compelling and the need is urgent.” Furthermore, Canadians should be “scandalized” that telestroke is lacking in most parts of the country, including those that need it most.

Caring for stroke patients via telestroke is that successful because it increases access to the clot-dissolving drug tPA that can reduce stroke damage. In rural and remote areas, stroke patients get tPA at the same rate as those treated in larger centers. Doctor Frank Silver, a leader of Ontario’s telestroke program, says that "this is no longer an experimental approach to stroke care delivery. We're achieving the same outcomes as the best stroke centers in the province."

The telestroke network does not only benefit stroke patients directly. Since it provides them with better care, it also saves the health-care system money. In Alberta, the service saved more than 1 million dollar over four years, while the annual cost of running a telestroke site is 100,000 to 150,000 Dollars. This includes equipment, operating and salary costs.

According to Doctor Michael Hill of the Canadian Stroke Congress, “only two provinces have widespread telestroke for hyper-acute care – Ontario and Alberta. Underserviced provinces need to step up and deliver this low-cost, high-impact service."

The Bisby study covers a one-year period from 2010 to 2011. During this period, 12 stroke neurologists located in regional stroke centres, such as Ottawa and Toronto, treated 450 patients from 17 referring hospitals across the province. Of those patients, 42 per cent who arrived at hospital within the three-and-half-hour window of eligibility received the clot-dissolving drug tPA. At regional stroke centres, neurologists administered tPA to 48 per cent of eligible patients who arrived within the same time frame.; Source: Heart and Stroke Foundation of Canada