Stroke is a leading cause of death and disability world-wide. Stroke systems of care, integrated approaches to stroke care delivery, and the availability of resources for stroke care vary considerably across geographic regions, creating a risk for sub-optimal care.
The World Health Organization has committed to efforts to significantly reduce risk factors and mortality from non-communicable diseases by 2025. Mortality and morbidity from stroke could be significantly reduced through organized stroke care, including the implementation of evidence-based clinical practice guidelines and adoption of a continuous quality improvement philosophy and programs.
Acute stroke care focuses the acute inpatient care period after the hyperacute stage is completed. This phase of care usually starts from about 24 hours after stroke onset through the first 5 to 7 days. In this phase the patient becomes medically stable and care goals shift to ongoing stroke assessment, determining etiology, management of persistent symptoms, initiating recovery, early rehabilitation, and prevention of acute complications. Acute stroke care ideally involves healthcare providers with expertise in stroke care and takes place in a clinic or hospital stroke unit or ward, but may occur in other community settings, including the home, based on resource and facility availability. Acute stroke care focuses the acute inpatient care period after the hyperacute stage is completed. This phase of care usually starts from about 24 hours after stroke onset through the first 5 to 7 days. In this phase the patient becomes medically stable and care goals shift to ongoing stroke assessment, determining etiology, management of persistent symptoms, initiating recovery, early rehabilitation, and prevention of acute complications. Acute stroke care ideally involves healthcare providers with expertise in stroke care and takes place in a clinic or hospital stroke unit or ward, but may occur in other community settings, including the home, based on resource and facility availability. Please check WSO Road Map for Acute Stroke Care here: Read more
Introduction: Welcome to the WSO Future Leaders' project on Telestroke Care!
In the realm of stroke care, the use of telemedicine has emerged as a beacon of hope, ensuring timely and effective treatment for individuals in remote or underserved areas. However, the practical implementation of telestroke care in the acute setting varies significantly across regions, ranging from cutting-edge technology to more simplistic models. Explanatory note:
We examine telestroke networks designed for use among healthcare professionals operating within the emergency and acute inpatient hospital setting (<3 days after onset). We are excluding telerehabilitation networks and direct telemedicine consultations between doctors and patients. We define a telestroke system of care as provision of stroke expertise to remote sites with limited or no vascular neurology coverage, allowing rapid evaluation and treatment decisions by skilled and experienced stroke physicians.
Our Mission:
Our aim is to provide a comprehensive evidence base to guide informed decision-making and to facilitate the ethical and effective implementation of telestroke care, ultimately improving stroke care outcomes for populations in both remote and underserved areas.
Objectives:
- Exploring Telestroke Care Models: We will delve into the diverse telestroke care models employed worldwide, focusing on their unique workflows and technological frameworks.
- Benefits, Limitations, Essential Requirements and Barriers: We will critically assess the advantages and limitations of telestroke practices, taking into account financial and human resource implications, as well as data security concerns. We aim to define the fundamental prerequisites for successful telestroke care and pinpoint the obstacles faced during implementation.
- Recommendations: Ultimately, we aim to develop best practices for global provision of telestroke care
Methodology:
Our approach combines a systematic literature review with a survey to telestroke networks from different regions and countries. Our findings will be discussed in a consensus meeting with experts in the field of stroke.
Outcomes:
Our study aims to provide a guidance for the future of telestroke care by examining diverse practices and protocols. By elucidating the strengths and limitations specific to each model and region, we strive to facilitate the successful implementation of telestroke systems.
Our Team:
Ayush Agarwal, Matias Alet, Bogdan Ciopleias, Leonardo Carbonera, Tarig Fadalla,Stefan Gerner, Mirjam Heldner, Maria Junaidi, Zhe Kang Law, Aris Katsanos, Abdul Hanif Khan, Linxin Li, Sarah Matuja, Jatinder Minhas, Emily Ramage, Tamer Roushdy, Javier Lagos Servellon, Christine Tunkl, Teresa Ulberg, Faddi Saleh Velez, Yvonne Zuurbier, Pawel Kiper, Gisele Sampaio Silva, Padma Vasantha,
Our expected milestones
Autumn 2023: Distribution of survey to network coordinators, Systematic literature review. Winter 2023: Data analysis. Spring 2023: Round table. Summer 2023: Development of recommendations. October 2024:Presentation of results at World Stroke Congress in Abu Dhabi
for more info contact: christine.tunkl@med.uni-heidelberg.de
Achieving our vision of a life free from stroke is a task that WSO cannot achieve alone. We are committed to building our partnerships at the global, regional and national level to scale up and deliver improvements in prevention, treatment and support to reduce the burden of stroke.
With support from:
*All WSO educational programs are independently developed and delivered.