In Canada, strokes are responsible for approximately 16,000 deaths per year, making it the fourth highest cause of death.1 For non-fatal cases, the burden associated with stroke is heavy for both patients and caregivers due to long-term disability, lowered ability to perform daily tasks, the cost of care, and lost productivity.2 Strokes can be hemorrhagic or ischemic, with ischemic strokes accounting for approximately 80% of all strokes. In order to decrease the burden and increase positive outcomes for patients with acute stroke, rapid assessment and treatment is important.2,3
One treatment option for acute ischemic stroke is systemic thrombolysis treatment, using tissue plasminogen activator (tPA). Thrombolysis treatment dissolves the clot that is obstructing blood flow to the brain, preventing permanent damage and is therefore associated with favourable outcomes.2,3 There is a narrow treatment window for thrombolysis treatment; it must be delivered within three hours of symptom onset, and it requires specific neurological expertise in order to guide the decision-making regarding ideal candidates for the treatment. As most stroke experts are located in major centres, patients in rural or remote areas are unlikely to receive thrombolysis treatment unless remote physicians are able to liaise with stroke experts in order to help guide decision-making and treatment planning. Telehealth and telemedicine are options used in order to link remote physicians with experts for this purpose.2,3
Telehealth and telemedicine can include telephone consultation, the transfer of digital imaging results via email or secure website, videoconferencing where the clinical encounter is guided by a stroke expert in a stroke centre, and various combinations of these modalities. This report will review the clinical evidence available regarding technologies used that assist with remote consultations for the diagnosis and treatment planning for patients presenting with symptoms of acute stroke or transient ischemic attack.
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Canadian Agency for Drugs and Technologies in Health, Ottawa (ON)
NLM Citation
Technologies Assisting in Remote Consultations for the Diagnosis of Stroke: A Review of the Clinical Evidence [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2013 Nov 25. CONTEXT AND POLICY ISSUES.