Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jan 30, 2020
Open Peer Review Period: Jan 30, 2020 - Mar 26, 2020
(currently open for review)
Development of a Comprehensive Telestroke Network to Optimize Healthcare Delivery for Cerebrovascular Diseases
Healthcare delivery for cerebrovascular diseases is a complex process, which may be improved using telestroke networks.
The purpose of this work was to establish and implement a protocol for the management of patients with acute stroke symptoms according to the available treatment alternatives at the initial point of care and the transfer possibilities.
The review board of our institutions approved this work. The protocol was based on the latest guidelines of the American Heart Association and American Stroke Association. Stroke care requires human and technological resources, which may differ according to the patients’ point of entry into the healthcare system. Three healthcare settings were identified to define the appropriate protocols: primary healthcare setting, intermediate healthcare setting, and advanced healthcare setting.
A user-friendly web-based telestroke solution was developed. The predictors, scales and scores implemented in this system allow the assessment of the vascular insult severity and the neurological status of the patient. The total number of possible pathways implemented were as follows: 10 in the primary healthcare setting, 39 in the intermediate healthcare setting, and 1162 in the advanced healthcare setting.
The developed comprehensive telestroke platform is the first stage in optimizing healthcare delivery for patients with stroke symptoms, regardless of the entry point into the emergency network, in both urban and rural regions. Conclusion. This system supports healthcare personnel by providing adequate inpatient stroke care and facilitating the prompt transfer of patients to a more appropriate healthcare setting if necessary, especially for patients with acute ischemic stroke within the therapeutic window who are candidates for reperfusion therapies, ultimately contributing to mitigating the mortality and mobility associated with stroke.
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