Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan
Background: Telemedicine helps to provide the safe management of stroke patients in the emergency department (ED) and has been used worldwide. However, we had limited experience of telestroke in Taiwan. We aimed to identify the quality of telestroke and compare it with the original face-to-face cons...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621001819 |
| _version_ | 1818873890942746624 |
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| author | Chun-Hsiang Lin Kwo-Whei Lee Ta-Cheng Chen Jian-Hui Lin Ke-Ru Liaw Pi-Ju Hsiao Wei-Ying Tsai Mu-Chien Sun |
| author_facet | Chun-Hsiang Lin Kwo-Whei Lee Ta-Cheng Chen Jian-Hui Lin Ke-Ru Liaw Pi-Ju Hsiao Wei-Ying Tsai Mu-Chien Sun |
| author_sort | Chun-Hsiang Lin |
| collection | DOAJ |
| description | Background: Telemedicine helps to provide the safe management of stroke patients in the emergency department (ED) and has been used worldwide. However, we had limited experience of telestroke in Taiwan. We aimed to identify the quality of telestroke and compare it with the original face-to-face consultation model. Methods: Among 178 consecutive acute ischemic stroke patients treated with intravenous tissue plasminogen activator (IVtPA) from January 1, 2018, to December 31, 2019, we compared two different consultation methods: face-to-face consultation and telestroke consultation. We collected data on demographics, the National Institutes of Health Stroke Scale (NIHSS) scores, Modified Rankin Scale (mRS) scores, time measurements (onset-to-arrival time, onset-to-telestroke activation time, and time of IVtPA administration (Door-to-Needle; DTN)). Results: The mean age to receive a telestroke consultation was 66.6 years, 36% were female, and the median NIHSS score was 9. The median time from patient arrival to telestroke consult activation was 40 min, and the median DTN time was 11 min longer than for face-to-face consults (62 min versus 51 min, p = .01). Telestroke consultation, similar to a face-to-face consultation, resulted in safe IVtPA eligibility assessments and administration with post-thrombolysis ICH in 4% overall (4% telestroke, 3% face-to-face consultation; p = .851). The 90-day outcomes were not different for mRS score, dichotomized 0–2 (60% telestroke 59% face-to-face consultation; p = .961), or for mortality (16% telestroke, 9% face-to-face consultation; p = .292). Conclusion: In the ED, consultation via the telestroke program provides equal quality to the original face-to-face consultation model to manage ischemic stroke. |
| first_indexed | 2024-12-19T13:01:54Z |
| format | Article |
| id | doaj.art-99f11f1386e3486f836b1645c501dda8 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-19T13:01:54Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-99f11f1386e3486f836b1645c501dda82022-12-21T20:20:14ZengElsevierJournal of the Formosan Medical Association0929-66462022-01-011211314318Quality and safety of Telemedicine in acute ischemic stroke: Early experience in TaiwanChun-Hsiang Lin0Kwo-Whei Lee1Ta-Cheng Chen2Jian-Hui Lin3Ke-Ru Liaw4Pi-Ju Hsiao5Wei-Ying Tsai6Mu-Chien Sun7Department of Neurology, Yuanlin Christian Hospital, Yuanlin, TaiwanDepartment of Radiology, Yuanlin Christian Hospital, Yuanlin, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua, TaiwanDepartment of Neurology, Yuanlin Christian Hospital, Yuanlin, TaiwanDepartment of Neurology, Yuanlin Christian Hospital, Yuanlin, TaiwanStroke Center, Changhua Christian Healthcare System, TaiwanDepartment of Neurology, Yuanlin Christian Hospital, Yuanlin, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Stroke Center, Changhua Christian Healthcare System, Taiwan; Corresponding author. Department of Neurology, Changhua Christian Hospital, No. 135, Nanhsiao Street, Changhua, 500, Taiwan. Fax: +4 7232942.Background: Telemedicine helps to provide the safe management of stroke patients in the emergency department (ED) and has been used worldwide. However, we had limited experience of telestroke in Taiwan. We aimed to identify the quality of telestroke and compare it with the original face-to-face consultation model. Methods: Among 178 consecutive acute ischemic stroke patients treated with intravenous tissue plasminogen activator (IVtPA) from January 1, 2018, to December 31, 2019, we compared two different consultation methods: face-to-face consultation and telestroke consultation. We collected data on demographics, the National Institutes of Health Stroke Scale (NIHSS) scores, Modified Rankin Scale (mRS) scores, time measurements (onset-to-arrival time, onset-to-telestroke activation time, and time of IVtPA administration (Door-to-Needle; DTN)). Results: The mean age to receive a telestroke consultation was 66.6 years, 36% were female, and the median NIHSS score was 9. The median time from patient arrival to telestroke consult activation was 40 min, and the median DTN time was 11 min longer than for face-to-face consults (62 min versus 51 min, p = .01). Telestroke consultation, similar to a face-to-face consultation, resulted in safe IVtPA eligibility assessments and administration with post-thrombolysis ICH in 4% overall (4% telestroke, 3% face-to-face consultation; p = .851). The 90-day outcomes were not different for mRS score, dichotomized 0–2 (60% telestroke 59% face-to-face consultation; p = .961), or for mortality (16% telestroke, 9% face-to-face consultation; p = .292). Conclusion: In the ED, consultation via the telestroke program provides equal quality to the original face-to-face consultation model to manage ischemic stroke.http://www.sciencedirect.com/science/article/pii/S0929664621001819Ischemic strokeTelemedicineTelestrokeThrombolytics |
| spellingShingle | Chun-Hsiang Lin Kwo-Whei Lee Ta-Cheng Chen Jian-Hui Lin Ke-Ru Liaw Pi-Ju Hsiao Wei-Ying Tsai Mu-Chien Sun Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan Journal of the Formosan Medical Association Ischemic stroke Telemedicine Telestroke Thrombolytics |
| title | Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan |
| title_full | Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan |
| title_fullStr | Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan |
| title_full_unstemmed | Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan |
| title_short | Quality and safety of Telemedicine in acute ischemic stroke: Early experience in Taiwan |
| title_sort | quality and safety of telemedicine in acute ischemic stroke early experience in taiwan |
| topic | Ischemic stroke Telemedicine Telestroke Thrombolytics |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621001819 |
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