Stroke Rounds: Telestroke Delivers in Germany

Telemedicine technology provides specialists with the data necessary to assist clinicians at the bedside in stroke-related decision making for patients presenting at distant or under-equipped facilities.

A telestroke program in rural Bavaria cut door-to-needle times by half and the lag between symptom onset and first treatment by 20%, researchers said.

Telemedicine — the use of modern teleconferencing technology to evaluate patients remotely and to recommend treatment strategies — has increasingly been adopted in developed countries as a way to bring specialist care to rural areas where it is otherwise scarce or unavailable.

“The main findings of 10-year experience of TEMPiS showed that this type of telemedical stroke unit network is sustaining, offers state-of-the-art acute stroke care by increasing access to stroke units and improving thrombolysis service, and is associated with long-term improvement in terms of quality indicators of acute hospital care,” Muller-Barna and colleagues wrote.

In the stroke setting, it involves putting stroke neurologists located mainly in urban tertiary care centers on call to evaluate patients brought into community hospitals in distant towns.

In addition, among patients receiving thrombolytic therapy, the proportion getting it within the first hour after admission increased — from 26% in 2003 to 80% in 2012 (P<0.001).

And, 7-day in-hospital mortality in TEMPiS stroke patients declined from 5.0% to 3.1% during the study period.

Telemedicine technology as seen in this rural German town is right here in rural Michigan.  As an important note, Community Health Center of Branch County (CHC) already has this telemedicine technology. For stroke patients going to the ER at CHC, physicians have access to Neurologists (Stroke Specialists) in Fort Wayne by this teleconferencing technology. This is a very exciting service that CHC provides to all. Reviewed/posted Dr. Russell

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