International Stroke Conference
February 6–8, 2019
Deepak Gulati, MD
During the joint symposium on the last day of the ISC 2019 on Telestroke, multiple experts with different backgrounds addressed the challenges associated with Telestroke. Telestroke turns 20 in 2019, which reflects 2 decades of progress. It was more of proof of concepts in early 2000 while showing benefit of Telestroke in rural areas. Telestroke plays a predominant role in the ‘Drip and Ship’ model in the United States, whereas the focus has been on Telestroke-supported stroke units in Europe. In the U.S., the Congress also authorized the payment for Medicare FFS Telestroke regardless of patient location in the “Furthering Access to Stroke Telemedicine” FAST Act. The future of Telestroke research will be on value (~quality/cost) vs churn, true econometric analyses, adoption within health system, scalability, disparities in access, continuum of care and Telestroke on call expertise vs AI. Based on data provided, there appears to be a connection between door-to-needle time with the number of consults from spoke hospitals. 50% of the Telestroke consults are usually acute stroke, and the rate of IVtpa administration increases with the number of consults performed. It’s expected to have the involvement of artificial intelligence in the future to deal with increasing demand of Telestroke.