Benefits and drawbacks Telestroke and use of Telemedicine for Stroke Care Treatm

Posted by Thomas Shaw on January 13th, 2021



Telestroke - Use of Telemedicine for Stroke Care



Did you realize that the stroke burden in India is estimated to be more than 1.5 million per year, out of which 70%-80% are ischemic, with nearly 1 stroke each and every 40 seconds and stroke related-death each 4 minutes! Shocking isn’t it! As per the Indian Stroke Association (ISA) 2018, strokes are the second most major result in of death in India along with the cases have risen by 17.5% over the last 15 years. At this backdrop, there’s a pressing want for establishing correct stroke care systems by utilizing Telestroke services to provide improved and timely care to individuals across the nation. Specially, in regards to rural locations exactly where access to excellent and advanced treatment options are restricted, Telestroke management could possibly be a boon. Just before we look at the options of bridging the significant gap that presently exists in stroke care, let’s comprehend what it implies in addition to its applications. Get far more info about Benefits of Telestroke





What's Telestroke? What does the Telestroke network comprise of?

Telestroke can be a web-based approach for treating stroke patients by the electronic transfer of data (such as imaging and signs) having a specific camera and microphones to facilitate communication amongst any two locations. It permits a neurologist to examine a patient at another hospital that might be miles away and to treat by means of thrombolysis by communicating with all the onsite physician offered together with the patient. This really is carried out using the use of real-time audio-visual technology that might support in enhancing outcomes in sufferers receiving this life-saving treatment at the ideal time. The Telestroke model supplies the foundation for collaborative, inter-professional care and augments local services which can be not quickly obtainable. How - by leveraging remote knowledge, resources, along with the standardization of processes. As ‘time-loss could result in brain-loss! ‘



Intriguing Fact

In India, the initial Telestroke hub and spoke model was used (using WhatsApp) within tertiary care hospitals in Himachal Pradesh, as a hub (with neurologist) and district hospitals as spokes (without neurologists). The neurologists in district hospitals had been educated for stroke treatment and the ‘tissue plasminogen activator (tPA)’ was made readily available at all these centres free of price via hospital pharmacies. Neurologists at 2 tertiary care centres have been made obtainable for consultation over phones. Around 26 sufferers had received thrombolysis treatment by means of Telestroke and only two patients developed an intracranial bleed following thrombolysis, and both have been nonfatal.



Varieties of Stroke

You will find mainly 3 types of stroke: transient ischemic attack (mini-stroke), ischemic stroke, and haemorrhagic stroke. Nearly 87% of acute strokes are ischemic and also the treatment/recovery rely upon the type of stroke one has. Time is the most significant aspect for treating a stroke patient as those that are treated inside 90 minutes of a stroke have a drastically lower risk of permanent brain damage or death. Acute stroke is often a time-sensitive situation, and in most of the cases, the therapeutic window for thrombolytic therapy (tPA) is much less than 4.5 hrs. for it to be effective.



What exactly is telestroke



How does it work?

“I can examine an individual very interactively using the assistance of a doctor or possibly a nurse on the other end and I can choose of your stroke severity plus the style of stroke by searching in the patient along with the brain image, it’s nearly like being inside the room.”



These words Dr Schwamm, a neurologist from Massachusetts General Hospital, states the effectiveness of Telestroke in treating stroke sufferers who are not inside the proximity of stroke sufferers or obtainable ‘in-person’ for urgent care.



In a Telestroke consultation, if your primary physician suspects acute stroke symptoms, he/she will activate the stroke telemedicine hotline at the distant hospital; authorities are normally on call 24/7. The distant site’s on-call doctor normally responds within minutes. The neurologist at the distant site performs a live, real-time audio/video consultation, evaluates the patient’s test outcomes and, performs along with your doctor to identify probably the most suitable treatment option. The neurologist also sends the treatment recommendation electronically to the hospital where the patient is getting monitored.



What’s vital for better outcomes - identifying, addressing and monitoring progress at all stages of the consultation and post it too.



Benefits of Telestroke

The target of a Telestroke consultation is always to maximize a patient’s recovery (minimizing brain damage) by generating an accurate diagnosis, figuring out eligibility for short-term therapy, and delivering the chosen treatment. In addition to this, other benefits of Telestroke are:



Reduced healthcare fees

24/7 service so emergent/non-emergent sufferers are catered to

Treatment options such as clot-busting drugs may be administered sooner

 Helps in reducing the threat for stroke-related disability

Makes it possible for on-going professional treatment at the patient’s local hospital and reduces the necessity for individuals to transfer to a different hospital

Remote access to many healthcare facilities so a lot more sufferers are addressed on time

COVID and remote health monitoring

The COVID-19 outbreak has made remote monitoring the new standard and it looks like a trend that's right here to stay, with or without having the pandemic.



A recent case of a 75 years old patient from the rural community may well support this claim. Within 40 minutes of his stroke onset, distinct symptoms such as a facial droop, weakness, and numbness of the appropriate arm, slurred speech have been observed. Due to Telestroke care, on connecting using a neurologist via a video get in touch with, the physician addressing him was capable to administer TPA right after exclusion of haemorrhage within 3 hours. Saved his life and brain damage as well! Because the pandemic imposes movement restrictions, the consulting neurologist, without the need of any interruption was able to monitor his actions on a daily basis and was able to obtain a much more precise reading of his situations.



A stroke survivor’s struggle with performing basic activities may be tough but being aware of that you just have a doctor to seek the advice of anytime can offer you ample peace of mind.



Future and Conclusion

The primary aspect of connecting sufferers using the team of professionals for suggested stroke treatment via Telestroke may be accomplished in India only if thrombolysis and imaging techniques are produced out there at all levels of health care. Whereas, keeping in mind India’s flourishing technological sector and leading communication networks, Telestroke is just not only helpful for emergency cases but in addition within the pre-hospital ambulance setting, rehabilitation, the medical care unit, and outpatient stroke prevention clinics. This also suggests that bridging the gap between the neurologists and individuals that may be presently 1: 5 lakhs can be addressed. Telestroke care can strengthen the recovery of extra individuals along with lessening the percentage of damaging outcomes that currently take place.



A variety of healthcare facilities are producing efforts to improve quality and offerings of healthcare supplied inside the rural regions via Telestroke to a level comparable together with the urban regions. The ultimate concept should be to reduce mortality and morbidity price of stroke and enhance stroke care in India as it’s generally about patient care!

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Thomas Shaw

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Thomas Shaw
Joined: March 17th, 2018
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