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Telemedicine networks for acute stroke: an analysis of global coverage, gaps, and opportunities

Background: Despite the proven efficacy of telestroke in improving clinical outcomes by providing access to specialized expertise and allowing rapid expert hyperacute stroke management and decision-making, detailed operational evidence is scarce, especially for less developed or lower income regions...

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Hauptverfasser: Tunkl, Christine (VerfasserIn) , Agarwal, Ayush (VerfasserIn) , Ramage, Emily (VerfasserIn) , Velez, Faddi Saleh (VerfasserIn) , Roushdy, Tamer (VerfasserIn) , Ullberg, Teresa (VerfasserIn) , Li, Linxin (VerfasserIn) , Carbonera, Leonardo A (VerfasserIn) , Yusof Khan, Abdul Hanif Khan (VerfasserIn) , Ciopleias, Bogdan (VerfasserIn) , Law, Zhe Kang (VerfasserIn) , Katsanos, Aristeidis H (VerfasserIn) , Heldner, Mirjam R (VerfasserIn) , Khan, Maria (VerfasserIn) , Matuja, Sarah (VerfasserIn) , Alet, Matias J (VerfasserIn) , Lagos-Servellón, Javier (VerfasserIn) , Minhas, Jatinder S (VerfasserIn) , Zuurbier, Susanna M (VerfasserIn) , Mosconi, Maria Giulia (VerfasserIn) , Lotlikar, Radhika (VerfasserIn) , Elkady, Ahmed (VerfasserIn) , Gerner, Stefan T (VerfasserIn) , Shreyan, Shirsho (VerfasserIn) , Krauß, Alexandra (VerfasserIn) , Gumbinger, Christoph (VerfasserIn) , Srivastava, Padma (VerfasserIn) , Kiper, Pawel (VerfasserIn) , Ohannessian, Robin (VerfasserIn) , Berberich, Anne (VerfasserIn) , Sampaio Silva, Gisele (VerfasserIn) , Ranta, Anna (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: March 2025
In: International journal of stroke
Year: 2025, Jahrgang: 20, Heft: 3, Pages: 297-309
ISSN:1747-4949
DOI:10.1177/17474930241298450
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/17474930241298450
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/17474930241298450
Volltext
Verfasserangaben:Christine Tunkl, Ayush Agarwal, Emily Ramage, Faddi Saleh Velez, Tamer Roushdy, Teresa Ullberg, Linxin Li, Leonardo A Carbonera, Abdul Hanif Khan Yusof Khan, Bogdan Ciopleias, Zhe Kang Law, Aristeidis H Katsanos, Mirjam R Heldner, Maria Khan, Sarah Matuja, Matias J Alet, Javier Lagos-Servellón, Jatinder S Minhas, Susanna M Zuurbier, Maria Giulia Mosconi, Radhika Lotlikar, Ahmed Elkady, Stefan T Gerner, Shirsho Shreyan, Alexandra Krauss, Christoph Gumbinger, Padma Srivastava, Pawel Kiper, Robin Ohannessian, Anne Berberich, Gisele Sampaio Silva and Anna Ranta
Beschreibung
Zusammenfassung:Background: Despite the proven efficacy of telestroke in improving clinical outcomes by providing access to specialized expertise and allowing rapid expert hyperacute stroke management and decision-making, detailed operational evidence is scarce, especially for less developed or lower income regions. - Aim: We aimed to map the global telestroke landscape and characterize existing networks. - Methods: We employed a four-tiered approach to comprehensively identify telestroke networks, primarily involving engagement with national stroke experts, stroke societies, and international stroke authorities. A carefully designed questionnaire was then distributed to the leaders of all identified networks to assess these networks’ structures, processes, and outcomes. - Results: We identified 254 telestroke networks distributed across 67 countries. High-income countries (HICs) concentrated 175 (69%) of the networks. No evidence of telestroke services was found in 58 (30%) countries. From the identified networks, 88 (34%) completed the survey, being 61 (71%) located in HICs. Network setup was highly heterogeneous, ranging from 17 (22%) networks with more than 20 affiliated hospitals, providing thousands of annual consultations using purpose-built highly specialized technology, to 11 (13%) networks with fewer than 120 consultations annually using generic videoconferencing equipment. Real-time video and image transfer was employed in 64 (75%) networks, while 62 (74%) conducting quality monitoring. Most networks established in the past 3 years were located in low- and middle-income countries (LMICs). - Conclusion: This comprehensive global survey of telestroke networks found significant variation in network coverage, setup, and technology use. Most services are in HICs, and a few services are in LMICs, although an emerging trend of new networks in these regions marks a pivotal moment in global telestroke care. The wide variation in quality monitoring practices across networks, with many failing to report key performance metrics, underscores the urgent need for standardized, resource-appropriate, quality assurance measures that can be adapted to diverse settings.
Beschreibung:Online verfügbar: 26. Oktober 2024
Gesehen am 04.06.2025
Beschreibung:Online Resource
ISSN:1747-4949
DOI:10.1177/17474930241298450

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