Funding: Victorian Government Department of Innovation, Industry and Regional Development, The Florey Institute of Neurosciences and Mental Health, Victorian Stroke Clinical Network – Victorian Department of Health, and Windermere Foundation. The Florey acknowledges the strong support from the Victorian Government and in particular the funding from the Operational Infrastructure Support Grant.
Establishment of an effective acute stroke telemedicine program for Australia: protocol for the Victorian Stroke Telemedicine project
Article first published online: 22 OCT 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 9, Issue 2, pages 252–258, February 2014
How to Cite
Cadilhac, D. A., Moloczij, N., Denisenko, S., Dewey, H., Disler, P., Winzar, B., Mosley, I., Donnan, G. A. and Bladin, C. (2014), Establishment of an effective acute stroke telemedicine program for Australia: protocol for the Victorian Stroke Telemedicine project. International Journal of Stroke, 9: 252–258. doi: 10.1111/ijs.12137
- Issue published online: 20 JAN 2014
- Article first published online: 22 OCT 2013
Urgent treatment of acute stroke in rural Australia is problematic partly because of limited access to medical specialists. Utilization of telemedicine could improve delivery of acute stroke treatments in rural communities.
The study aims to demonstrate enhanced clinical decision making for use of thrombolysis within 4·5 h of ischemic stroke symptom onset in a rural setting using a telemedicine specialist support model.
A formative program evaluation research design was used. The Victorian Stroke Telemedicine program was developed and will be evaluated over five stages to ensure successful implementation. The phases include: (a) preimplementation phase to establish the Victorian Stroke Telemedicine program including the clinical pathway, data collection tools, and technology processes; (b) pilot clinical application phase to test the pathway in up to 10 patients; (c) modification phase to refine the program; (d) full clinical implementation phase where the program is maintained for one-year; and (e) a sustainability phase to assess project outcomes over five-years. Qualitative (clinician interviews) and quantitative data (patient, clinician, costs, and technology processes) are collected in each phase.
The primary outcome is to achieve a minimum 10% absolute increase in eligible patients treated with thrombolysis. Secondary outcomes are utilization of the telestroke pathway and improvements in processes of stroke care (e.g., time to brain scan). We will report door to telemedicine consultation time, length of telemedicine consultation, clinical utility and acceptability from the perspective of clinicians, and 90-day patient outcomes.
This research will provide evidence for an effective telestroke program for use in regional Australian hospitals.