Virtual Stroke Care: Before, During and After Hospitalization

Stroke is a leading disability in the United States that affects more than 795,000 people each year. Outcomes after stroke are heavily influenced by the ability to receive time-dependent care such as intravenous clot busters, device clot removal therapy and post-stroke rehabilitation.

Unfortunately, barriers exist which influence access to stroke care, particularly a person being in a remote location away from a major medical center. This can result in delays throughout their care continuum.

Virtual stroke care utilizing video conferencing technology can bridge gaps from before patients arrive to the hospital all the way to post-acute settings, allowing stroke expertise to be brought to the patient instead of relying on patients traveling to stroke specialists.

[Read: A Beginner’s Guide to a Virtual Doctor’s Visit.]

Virtual Stroke Care Before Hospitalization

For many stroke patients, their first encounter with stroke care is in the ambulance. After 911 is called, trained paramedics perform an initial assessment using stroke screening tools, initiate basic treatment, transport patients to local hospitals for further evaluation and may occasionally bypass local hospitals for larger certified stroke centers.

Travel can take just a few minutes or up to hours depending on how far the patient is from their local hospital. Knowing that stroke patients can lose about 1.9 million brain cells each minute, time to treatment is crucial. Some sites in the country are collaborating with their local EMS teams to have videoconference capability between the ambulance and the hospital, allowing a head start on assessment of the patient before they reach the facility.

A major advance is the development of mobile stroke treatment units — highly specialized ambulances that look fairly typical on the outside but contain advanced diagnostic and treatment capabilities that make them small emergency rooms on wheels. Through a high speed connection, stroke specialists can remotely evaluate patients and bring advanced stroke care directly to their door step.

Mobile stroke units have been shown to significantly reduce time to treatment, increase the chances of receiving acute stroke treatment and help patients achieve better outcomes. Mobile stroke units are not available in every city; however, due to both the effectiveness of these specialized ambulances and community need, mobile stroke units are growing both within the United States and worldwide. With virtual care in the pre-hospital setting, patients are brought to the right hospital the first time.

[READ: Mental Exercises to Keep Your Brain Sharp.]

Virtual Stroke Care During a Hospital Stay

Once stroke patients present to an emergency room or are admitted to the hospital, they may interact with a stroke specialist virtually in different phases of their hospital stay. Telestroke is becoming an increasingly popular solution to optimize stroke care for patients, regardless of their geographic location.

In a traditional setting, a neurologist would interact with an ED physician on the phone or drive into the hospital to personally evaluate the patient. Telestroke enables stroke specialists to directly evaluate patients virtually within minutes of being called and utilize technology to review images, laboratory results and other pertinent information.

Emergency room teams and telestroke specialists work closely together to determine eligibility for acute stroke therapy and safely triage patients. Telestroke can also help prevent unnecessary hospital transfers and keep more patients in their communities unless transfer is required for advanced stroke care.

Some hospitals have “connected hospital units.” These specialized hospital units have videoconferencing equipment and advanced neurologic monitoring built into each room. This allows providers to virtually assess and provide updates to patients and families.

[READ: Why Should I Be Referred to a Neurologist?]

Virtual Visits After Stroke Hospitalization

Many stroke patients develop physical or cognitive deficits after a stroke. As patients undergo stroke rehabilitation to regain physical and cognitive function, their ability to travel might be impacted by mobility issues associated with their stroke. This can lead to patients missing important outpatient appointments with specialists to ensure they are receiving appropriate follow-up care, answer questions and potentially avoid hospitalization.

Though virtual visits have been utilized for many years, the COVID-19 pandemic has accelerated the use and comfort for both caregivers and patients alike. This not only allows patients to receive timely outpatient follow-up stroke care without the need to travel, but also affords patients located far away to connect with specialists with the need for costly travel and hotel accommodations. Virtual visits have become a preferred option for both stroke patients and stroke specialists due its ease of use, efficiency and cost-effectiveness.

Just as technological advances in videoconferencing technology have allowed more ways for people to connect both personally and for work, these same advances have opened a great opportunity for medical care, especially for time sensitive emergencies such as stroke. The application of these technologies will continue to push enhance care, allowing better outcomes for patients in many locations.

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Virtual Stroke Care: Before, During and After Hospitalization originally appeared on

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