Rural Telestroke Program Provides Model of Care

A new study demonstrates that a telestroke program implemented in Bavaria (Germany) could provide sustained high-quality stroke care in rural areas.

Researchers at Städtisches Klinikum München (Germany), University Hospital Würzburg (Germany), and other institutions in Germany conducted a study to evaluate the implementation of the TeleMedical Project for integrative Stroke Care (TEMPiS) in Southeast Bavaria during 2003–2005. The researchers assessed diagnostics, treatment, and outcomes, including rates and timeliness of intravenous thrombolysis, data on teleconsultations, and secondary interhospital transfers.

The results showed that within the covered area, network implementation increased the number of patients with stroke and transient ischemic attack (TIA) treated in hospitals with substantially, from 19% to 78%. In all, 54,804 strokes and TIAs were treated in 15 regional hospitals, with 31,864 teleconsultations were performed. Intravenous thrombolysis was applied in 3,331 stroke cases, an increase from 2.6% to 15.5% of all patients with ischemic stroke. Median onset-to-treatment times decreased from 150 to 120 minutes, and door-to-needle times from 80 to 40 minutes.

“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,” concluded lead author Peter Müller-Barna, MD, of Städtisches Klinikum München, and colleagues.

The TEMPiS telemedical system consists of a digital network including a 2-way video conference and CT/MRI-image transfers using a high-speed-data transmission. This allows stroke experts stationed at stroke centers in Munich-Harlaching and at the University of Regensburg to be consulted using the 2-way video conference. They can observe patients, talk to them directly and examine them with the help of the local physician.

Related Links:
Städtisches Klinikum München
University Hospital Würzburg