Role of telemedicine in the management of acute ischemic stroke

Department of Ageing & Health, 9th Floor, North Wing, St Thomas’ Hospital, London SE1 7EH, UK *Author for correspondence: Tel.: +44 207 188 2515; Fax: +44 207 928 2339; [email protected] summary Inequalities for care of stroke patients have been demonstrated between different locations and at different times of the week. In order to overcome the inequity of access to specialist stroke care, telemedicine systems that have harnessed computer-based technology have been developed to provide remote specialist assessment of patients with realtime clinical evaluation. An electronic database search was performed of MEDLINE, EMBASE and the Cochrane Library, and extensive manual searching of articles was conducted to identify studies investigating the use of telemedicine in managing acute ischemic stroke. A total of 31 observational and three randomized controlled studies involving 18,690 patients met inclusion criteria. Telemedicine was demonstrated to be safe, effective, feasible and acceptable for managing acute ischemic stroke. It was shown to reduce geographical differences, and increase diagnostic accuracy and uptake of thrombolytic treatment. Practice Points