Impact of telemedicine on access to acute stroke care in the state of Texas

Authors

  • Tzu-Ching Wu,

    Corresponding author
    1. Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, Texas 77030
    • Correspondence

      Tzu-Ching Wu, Department of Neurology, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 7.120, Houston, TX 77030. Tel: +1 713-500-7082; Fax: +1 713-500-0660; E-mail: Tzu-ching.wu@uth.tmc.edu

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    • Dr. Wu and Dr. Lyerly contributed equally to the development of the manuscript.
  • Michael J. Lyerly,

    1. Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294
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    • Dr. Wu and Dr. Lyerly contributed equally to the development of the manuscript.
  • Karen C. Albright,

    1. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294
    2. Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, Alabama 35294
    3. Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health and Health Disparities Research Center (MHRC), University of Alabama at Birmingham, Birmingham, Alabama 35294
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  • Eric Ward,

    1. Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, Texas 77030
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  • Amanda Hassler,

    1. Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, Texas 77030
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  • Jessica Messier,

    1. Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, Texas 77030
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  • Catherine Wolff,

    1. Department of Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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  • Charles C. Brannas,

    1. Department of Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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  • Sean I. Savitz,

    1. Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, Texas 77030
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    • Co-senior authors.
  • Brendan G. Carr

    1. Department of Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
    2. Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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    • Co-senior authors.

Errata

This article is corrected by:

  1. Errata: Impact of telemedicine on access to acute stroke care in the state of Texas Volume 1, Issue 6, 451, Article first published online: 19 June 2014

Abstract

Background

To examine the impact of telemedicine (TM) on access to acute stroke care and expertise in the state of Texas.

Methods

Texas hospitals were surveyed using a standard questionnaire and categorized as: (1) stand-alone Primary Stroke Centers (PSC) not using TM for acute stroke care, (2) PSC using TM for acute stroke care, (3) non-PSC hospitals using TM for acute stroke care, or (4) non-PSC hospitals not using TM for acute stroke care. Population data were obtained from the U.S. Census Bureau and the Neilson Claritas Demographic Estimation Program. Access within 60 min to a designated facility was calculated at the block group level.

Results

Over 75% of Texans had 60-min access to a stand-alone PSC. Including PSC using TM increased access by 6.5%. Adding non-PSC that use TM for acute stroke care provided 60-min access for an additional 2% of Texans, leaving 16% of Texans without 60-min access to acute stroke care. Approximately 62% of Texans had 60-min access to more than one type of facility that provided acute stroke care.

Conclusion

The use of TM in the state of Texas brought 60-min access to >2 million Texans who otherwise would not have had access to acute stroke expertise. Our findings demonstrate that using TM for acute stroke has the ability to provide neurologically underserved areas access to acute stroke care.

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