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Exploring the benefits of a stroke telemedicine programme: An organisational and societal perspective
Discussions with the Victorian Stroke Telemedicine management were undertaken and field notes were also reviewed. Several benefits of telemedicine were identified within and across participating hospitals, as well as for the state government and community. For hospitals, standardisation of clinical processes was reported, including improved stroke care co-ordination. Capacity building occurred through professional development and educational workshops. Enhanced networking, and resource sharing across hospitals was achieved between hospitals and organisations. Governments leveraged the Victorian Stroke Telemedicine programm...
Source: Journal of Telemedicine and Telecare - October 29, 2016 Category: Information Technology Authors: Bagot, K. L., Bladin, C. F., Vu, M., Kim, J., Hand, P. J., Campbell, B., Walker, A., Donnan, G. A., Dewey, H. M., Cadilhac, D. A., on behalf of the VST collaborators Tags: Special Issue - SFT 2016 Source Type: research

The cost-effectiveness of telestroke in the Pacific Northwest region of the USA
Conclusions Our results support previous models showing good value, overall. However, costs and ICERs varied by stroke severity, with telestroke being most cost-effective for severe strokes. Telestroke was least cost effective for the spokes if spokes paid for more than half of implementation costs.
Source: Journal of Telemedicine and Telecare - September 19, 2016 Category: Information Technology Authors: Nelson, R. E., Okon, N., Lesko, A. C., Majersik, J. J., Bhatt, A., Baraban, E. Tags: RESEARCH/Original Articles Source Type: research

The effects of telemedicine on racial and ethnic disparities in access to acute stroke care
Racial and ethnic disparities have been previously reported in acute stroke care. We sought to determine the effect of telemedicine (TM) on access to acute stroke care for racial and ethnic minorities in the state of Texas. Data were collected from the US Census Bureau, The Joint Commission and the American Hospital Association. Access for racial and ethnic minorities was determined by summing the population that could reach a primary stroke centre (PSC) or telemedicine spoke within specified time intervals using validated models. TM extended access to stroke expertise by 1.5 million residents. The odds of providing 60-min...
Source: Journal of Telemedicine and Telecare - March 4, 2016 Category: Information Technology Authors: Lyerly, M. J., Wu, T.-C., Mullen, M. T., Albright, K. C., Wolff, C., Boehme, A. K., Branas, C. C., Grotta, J. C., Savitz, S. I., Carr, B. G. Tags: RESEARCH/Original Articles Source Type: research

Association of time on outcome after intravenous thrombolysis in the elderly in a telestroke network
Conclusion Treatment time seems to be critical for favourable outcome after acute ischemic stroke in the elderly. Age is not associated with longer delivery times for thrombolysis in telestroke.
Source: Journal of Telemedicine and Telecare - December 18, 2015 Category: Information Technology Authors: Zerna, C., Siepmann, T., Barlinn, K., Kepplinger, J., Pallesen, L.-P., Puetz, V., Bodechtel, U. Tags: RESEARCH/Original Articles Source Type: research

Tele-emergency utilization: In what clinical situations is tele-emergency activated?
Discussion Although only used in 3.5% of ED encounters on average, our findings provide evidence that tele-emergency activation is well reasoned and related to those situations when extra expert assistance is particularly beneficial.
Source: Journal of Telemedicine and Telecare - December 18, 2015 Category: Information Technology Authors: Ward, M. M., Ullrich, F., MacKinney, A. C., Bell, A. L., Shipp, S., Mueller, K. J. Tags: RESEARCH/Original Articles Source Type: research

Patient Compliance in Home-Based Self-Care Telehealth Projects
This paper presents the findings of a literature review on patient compliance in home-based self-care telehealth monitoring situations, intended to establish a knowledge base for this aspect which is often neglected alongside more conventional clinical, economic and service evaluations. A systematic search strategy led to 72 peer-reviewed published scientific papers being selected as most relevant to the topic, 58 of which appeared in the last 10 years. Patient conditions in which most evidence for compliance was found were blood pressure, heart failure and stroke, diabetes, asthma, chronic obstructive pulmonary disease an...
Source: Journal of Telemedicine and Telecare - November 10, 2015 Category: Information Technology Authors: Maeder, A., Poultney, N., Morgan, G., Lippiatt, R. Tags: SFT 15 Supplement Source Type: research

Telemedicine in the acute health setting: A disruptive innovation for specialists (an example from stroke)
Conclusions Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine.
Source: Journal of Telemedicine and Telecare - November 10, 2015 Category: Information Technology Authors: Bagot, K. L., Cadilhac, D. A., Vu, M., Moss, K., Bladin, C. F., on behalf of the VST collaborators Tags: SFT 15 Supplement Source Type: research

Post t-PA transfer to hub improves outcome of moderate to severe ischemic stroke patients
Conclusions Patients with moderate to severe ischemic strokes who were treated with t-PA in a telestroke network may potentially benefit from expert care at a primary stroke center.
Source: Journal of Telemedicine and Telecare - September 18, 2015 Category: Information Technology Authors: Yaghi, S., Harik, S. I., Hinduja, A., Bianchi, N., Johnson, D. M., Keyrouz, S. G. Tags: RESEARCH/Original Articles Source Type: research

Telestroke, tele-oncology and teledialysis: a systematic review to analyse the outcomes of active therapies delivered with telemedicine support
We conducted a systematic review of studies involving telemedicine supervision of active treatment for rural patients in the fields of stroke, medical oncology and nephrology. Searches were performed on the MEDLINE, CINAHL and INFORMIT databases. A total of 521 articles were found, and an additional 42 articles were identified by searching the reference lists. After removing duplicates, screening the abstracts and assessing the full text of the articles, 14 articles remained. Nine concerned telestroke, two concerned tele-oncology and three concerned teledialysis. Most studies did not undertake randomisation, allocation con...
Source: Journal of Telemedicine and Telecare - June 3, 2015 Category: Information Technology Authors: Jhaveri, D., Larkins, S., Sabesan, S. Tags: RESEARCH/Systematic Reviews Source Type: research

Efficacy of telemedicine for thrombolytic therapy in acute ischemic stroke: a meta-analysis
The aim of this study was to assess the benefits of telemedicine in the delivery of thrombolytic therapy for patients with acute ischemic stroke. We performed a meta-analysis using combinations of the following terms: telestroke, telemedicine, tissue plasminogen activator/t-PA, and acute ischemic stroke. The primary outcome was favorable outcome based on the modified Rankin score. Secondary outcomes were incidence of symptomatic intracranial hemorrhage and overall mortality. We found no significant difference in favorable outcome between the telemedicine and control groups, and no significant difference was found between t...
Source: Journal of Telemedicine and Telecare - March 31, 2015 Category: Information Technology Authors: Zhai, Y.-k., Zhu, W.-j., Hou, H.-l., Sun, D.-x., Zhao, J. Tags: RESEARCH/Original articles Source Type: research

A randomized controlled trial on Stroke telerehabilitation: The effects on falls self-efficacy and satisfaction with care
We determined the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on falls-related self-efficacy and satisfaction with care. We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans from three Veterans Affairs Medical Centers. Participants who experienced a stroke in the past 24 months were randomized to the STeleR intervention or usual care. Participants in the intervention arm were administered an exit interview to gather specific patient satisfaction data three months after their final outcome measure. The STeleR intervention consisted of three home visits, five tel...
Source: Journal of Telemedicine and Telecare - March 31, 2015 Category: Information Technology Authors: Chumbler, N. R., Li, X., Quigley, P., Morey, M. C., Rose, D., Griffiths, P., Sanford, J., Hoenig, H. Tags: RESEARCH/Original articles Source Type: research

Telerehabilitation for older people using off-the-shelf applications: acceptability and feasibility
We investigated the feasibility of providing telerehabilitation in the home as an alternative to conventional ambulatory rehabilitation. Two groups of patients were accepted for telerehabilitation. The first group were community patients who needed rehabilitation, e.g. following a stroke, a fracture or prolonged hospital admission. The second group was from two rural nursing homes where residents were identified with a recent injury, fall or hospitalisation. Telerehabilitation employed a coaching model, with fewer therapist home visits, more feedback and "homework" for the patient. Patients had a tablet computer loaded wit...
Source: Journal of Telemedicine and Telecare - November 16, 2014 Category: Information Technology Authors: Crotty, M., Killington, M., van den Berg, M., Morris, C., Taylor, A., Carati, C. Tags: RESEARCH/Original articles Source Type: research

Experience with scaling up the Victorian Stroke Telemedicine programme
Telemedicine can be used to increase access to stroke thrombolysis in rural hospitals but is not widely used for this purpose in Australia. The Victorian Stroke Telemedicine (VST) programme commenced in one hospital in 2011, and is being expanded to a further 15 hospitals. The present study summarises progress in scaling up the VST programme from one to four hospitals. Patient and clinical consultation quantitative data obtained from 1 March 2014 until 30 June 2014 were reviewed. By August 2014, the VST programme was operational at the four hospital sites. During the period 1 March 2014 to 30 June 2014, a total of 42 patie...
Source: Journal of Telemedicine and Telecare - November 16, 2014 Category: Information Technology Authors: Cadilhac, D. A., Vu, M., Bladin, C. Tags: RESEARCH/Original articles Source Type: research