Working towards “no stroke untreated”: Planning for the Australian Telestroke Network

Abstract

Background: Disparities in stroke care between metropolitan and regional areas are well documented. The Victorian Stroke Telemedicine (VST) program seamlessly connects 16 regional hospitals to stroke specialists, for rapid assessment and treatment in Victoria, Australia. An Australia-wide telestroke service would be unique internationally. Aim: To identify the potential opportunity and benefits of upscaling an existing acute telestroke service in Victoria to all of regional Australia. Methods: After extensive consultation, 58 hospitals with suitable acute stroke care capabilities were identified to achieve coverage for regional Australia (Victoria n=16, New South Wales n=15, Queensland n=14, South Australia n=6,Western Australia n=3, Tasmania n=2, Northern Territory n=2). Data sources to extrapolate potential benefits to Australia included published literature, the myhospital.gov website and current treatment metrics data from the VST program. Results: With the ATN, delineated hospitals could treat approximately 14,500 stroke patients each year in regional Australia, with a 3.7 fold increase in stroke specialist consultations over current activity. Approximately 12 calls per day could be expected with a 26% increase in patients receiving thrombolysis, and a 26% increase in patients identified as suitable for clot retrieval. Thrombolysis could be delivered earlier, with a 1.8 fold increase in patients receiving thrombolysis within 60 minutes. Safer care would occur with a 57% reduction in post-thrombolysis bleeds. Discussion: The Australian Telestroke Network (ATN) could potentially improve access to stroke specialists to provide clinical decision-making and support more quickly and more safely. The ATN could reduce the recognised “post-code lottery” of acute stroke care that currently exists in Australia.L618235805 <br />