A recent survey of hospitals and other healthcare providers designed to understand the capacity and use of telestroke care in the Northwestern United States found 88 percent of respondents believe their rural communities suffer from a lack of stroke neurologists.

The survey was distributed online to members of the Washington State Department of Health Heart Disease and Stroke Prevention Program, Northwest Regional Telehealth Resource Center (NRTRC) and the Northwest Regional Stroke Network (NWRSN). Survey results were released by the Regional Telestroke Initiative (RTI), a collaborative effort to address stroke care in the Northwest region.

Sixty four percent of survey respondents said they are currently in the process or considering development of a telestroke program to address this lack of local neurology resources:

• 45 percent are in the process of developing an audio/visual telestroke program, 18 percent are considering it.
• 25 percent are not developing an audio/visual program
• 66 percent said availability of neurology resources is not prohibiting them from developing a telestroke program

The survey results show that development of A/V telestroke programs is impacted more by system requirements and funding, then by resources:

• Sixty-six percent of respondents represented accredited stroke centers.
• 56 percent had stroke legislation, which included the Washington State Emergency Cardiac and Stroke initiative and other state's telestroke reimbursement initiatives.

The upfront costs to providers who implement telestroke programs and professional consultations are not always covered by insurers, even though they may lead to reduced severity of impairment and future medical costs. Of those organizations currently providing telestroke services, the leading sources of funding are stroke specialty tertiary (hub) hospitals (28 percent) and grant funding (21 percent). And when it comes to reimbursement for a neurologist's on-call telestroke time, 32.6 percent report that the hub hospital covers the cost, and 32.6 percent report no reimbursement for the services they provide.

The study finds that sharing resources and personnel, whether that is between hubs and spokes or across state lines, is invaluable to sharing responsibility and not overburdening stroke neurologists, with about 75 percent of respondents indicating they did this.

According to the survey there is overwhelming interest in learning more about regional efforts around telestroke issues, with 36 percent of respondents indicating they wanted to participate in the development of a regional telestroke initiative, and 61 percent asking for more information about it.

Officials said RTI will continue to address persistent barriers to telestroke development and leverage the considerable expertise and infrastructure in the region to standardize practices and improve interstate licensure, credentialing and reimbursement.

The RTI is now planning educational opportunities to respond to the needs identified by the survey and build upon progress that has already been made. These educational opportunities will include best practices in the delivery of acute stroke treatment and successful telestroke solutions across the region. Additionally, RTI members will participate in efforts to remove state, regional and national policies that create barriers at both the provider and system levels.

Click here to see more results of the survey.