Christine Tunkl, Ayush Agarwal, Emily Ramage, Faddi Saleh Velez, Tamer Roushdy, Teresa Ullberg, Linxin Li, Leonardo Augusto Carbonera, Abdul Hanif Khan Yusof Khan, Bogdan Ciopleias, Zhe Kang Law, Aristeidis H Katsanos, Mirjam R Heldner, Maria Khan, Sarah Shali Matuja, Matias J Alet, Javier Lagos-Servellon, Jatinder S Minhas, Susanna Zuurbier, Maria Giulia Mosconi, Radhika Lotlikar, Ahmed Elkady, Stefan T Gerner, Shirsho Shreyan, Alexandra Krauss, Christoph Gumbinger, Padma Mv Srivastava, Pawel Kiper, Robin Ohannessian, Anne Berberich, Gisele Sampaio Silva, Anna Ranta
{"title":"治疗急性中风的远程医疗网络:对全球覆盖范围、差距和机遇的分析。","authors":"Christine Tunkl, Ayush Agarwal, Emily Ramage, Faddi Saleh Velez, Tamer Roushdy, Teresa Ullberg, Linxin Li, Leonardo Augusto Carbonera, Abdul Hanif Khan Yusof Khan, Bogdan Ciopleias, Zhe Kang Law, Aristeidis H Katsanos, Mirjam R Heldner, Maria Khan, Sarah Shali Matuja, Matias J Alet, Javier Lagos-Servellon, Jatinder S Minhas, Susanna Zuurbier, Maria Giulia Mosconi, Radhika Lotlikar, Ahmed Elkady, Stefan T Gerner, Shirsho Shreyan, Alexandra Krauss, Christoph Gumbinger, Padma Mv Srivastava, Pawel Kiper, Robin Ohannessian, Anne Berberich, Gisele Sampaio Silva, Anna Ranta","doi":"10.1177/17474930241298450","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>We aimed to map the global telestroke landscape and characterize existing networks.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 set-up was highly heterogenous, ranging from 17 (22%) networks with more than twenty 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 last three years were located in low- and middle-income countries (LMICs).</p><p><strong>Conclusions: </strong>This comprehensive global survey of telestroke networks found significant variation in network coverage, set-up, and technology use. Most services are in HICs, and 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.</p>","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":null,"pages":null},"PeriodicalIF":6.3000,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Telemedicine networks for acute stroke: an analysis of global coverage, gaps and opportunities.\",\"authors\":\"Christine Tunkl, Ayush Agarwal, Emily Ramage, Faddi Saleh Velez, Tamer Roushdy, Teresa Ullberg, Linxin Li, Leonardo Augusto Carbonera, Abdul Hanif Khan Yusof Khan, Bogdan Ciopleias, Zhe Kang Law, Aristeidis H Katsanos, Mirjam R Heldner, Maria Khan, Sarah Shali Matuja, Matias J Alet, Javier Lagos-Servellon, Jatinder S Minhas, Susanna Zuurbier, Maria Giulia Mosconi, Radhika Lotlikar, Ahmed Elkady, Stefan T Gerner, Shirsho Shreyan, Alexandra Krauss, Christoph Gumbinger, Padma Mv Srivastava, Pawel Kiper, Robin Ohannessian, Anne Berberich, Gisele Sampaio Silva, Anna Ranta\",\"doi\":\"10.1177/17474930241298450\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>We aimed to map the global telestroke landscape and characterize existing networks.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 set-up was highly heterogenous, ranging from 17 (22%) networks with more than twenty 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 last three years were located in low- and middle-income countries (LMICs).</p><p><strong>Conclusions: </strong>This comprehensive global survey of telestroke networks found significant variation in network coverage, set-up, and technology use. Most services are in HICs, and 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.</p>\",\"PeriodicalId\":14442,\"journal\":{\"name\":\"International Journal of Stroke\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.3000,\"publicationDate\":\"2024-10-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17474930241298450\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930241298450","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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.
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 set-up was highly heterogenous, ranging from 17 (22%) networks with more than twenty 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 last three years were located in low- and middle-income countries (LMICs).
Conclusions: This comprehensive global survey of telestroke networks found significant variation in network coverage, set-up, and technology use. Most services are in HICs, and 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.
期刊介绍:
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.