Telestroke 2017 Module Update

 

The 2017 update of the Canadian Stroke Best Practice Recommendations (CSBPR) Telestroke guideline is now available on the International Journal of Stroke website here. Every year, approximately 62,000 people with stroke and transient ischemic attack (TIA) are treated in Canadian hospitals. The Telestroke guidelines are a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require immediate transfer to stroke centres for Endovascular Therapy; and for the patients who remain in community hospitals that facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services.

The theme of the Sixth Edition of the CSBPR is Partnerships and Collaborations. This theme stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care of stroke patients to optimize recovery and outcomes.

Partnerships and Collaborations in Telestroke involve healthcare providers, policy makers, patients, and the public. Telestroke is a tool or care-delivery modality that can be used for both ‘on-demand’ (urgent, unplanned) and ‘scheduled’ access to specialized stroke services. To be successful, Telestroke has to be implemented within an established and coordinated stroke system, where stroke experts and referring sites can be connected in an efficient and organized manner and be available for other uses to maximize the value of investment.

Key messages from the 2017 Telestroke update include:

  • Telestroke as a care-delivery modality is under-utilized in Canada.
  • Telestroke should be implemented within established stroke systems of care to maximize effectiveness.
  • Telestroke applications include hyperacute care to increase access to acute thrombolysis and to support decision-making for endovascular therapy.
  • Telestroke applications are expanding and processes are being established to leverage Telestroke for broader use to support smaller stroke units with management of complex cases; increase access to rehabilitation services and specialists; provide secondary prevention services to areas where services are not available; and improve community support.

In addition to the updated guidelines a comprehensive implementation toolkit is available. The documents included in this toolkit are intended to support both consulting and referring sites with the implementation of Telestroke services in their facility. The information provided is considered a starting place – examples and templates provided for use by all sites to review, adopt or adapt to meet their own needs. To access the toolkit visit http://www.strokebestpractices.ca/index.php/telestroke/

The updated Telestroke recommendations are published in the International Journal of Stroke and are part of the sixth edition of the Heart and Stroke Foundation Canadian Stroke Best Practice Recommendations. Supporting information including rationale, system implications, performance measures and implementation resources are available online at the Heart and Stroke Foundation at http://www.strokebestpractices.ca/index.php/telestroke/

Click here to access the methodology on the CSPBR website.

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