In stroke telemedicine, also called telestroke, doctors who have advanced training in the nervous system (neurologists) remotely evaluate people who've had acute strokes and make diagnoses and treatment recommendations to emergency medicine doctors at other sites. Doctors communicate using digital video cameras, Internet telecommunications, robotic telepresence, smartphones and other technology.

Having a prompt neurological evaluation increases the possibility that you may receive clot-dissolving therapies (thrombolytics) or other clot-retrieving procedures in time to reduce disability and death resulting from stroke.

Read more about stroke.

About

In stroke telemedicine (telestroke), at Mayo Clinic, your doctor and the neurologist trained in blood vessel conditions (vascular neurologist) provide care in your home community and try to avoid the need for transfer to another medical center. This focus on regional care often allows you to receive quality stroke care in your community.

Stroke telemedicine operates on a hub-and-spoke system. A large urban medical center, generally certified as a primary or comprehensive stroke center, usually serves as the primary medical center (the hub). Remote locations, usually smaller regional rural or underserved hospitals, serve as the spokes. Many regional hospitals don't have neurologists on call to recommend the most appropriate care. In stroke telemedicine, a vascular neurologist at the hub consults with doctors and people who've had acute strokes at the remote sites (spokes).

In telestroke, many people work together as a team, including a program manager, a clinical coordinator, vascular neurologists, neurosurgeons and radiologists at the hub site, and emergency medicine doctors and other staff at the spoke site. Radiology technicians, informational technology staff, researchers, nurses, nurse practitioners and other staff also are important members of the stroke telemedicine team.

Stroke telemedicine consultation

In a stroke telemedicine consultation, an emergency medicine doctor at your regional hospital (the spoke) will examine you. If your doctor suspects an acute stroke, he or she will activate the stroke telemedicine hotline at the hub hospital, which has a dedicated hotline and group paging system and vascular neurologists on call 24 hours a day, 365 days a year. The hub's on-call vascular neurologist usually responds within five minutes.

After you have a CT scan at the spoke hospital, the vascular neurologist at the hub performs a live, real-time audiovisual consultation. The vascular neurologist may discuss your medical history and review your test results. The vascular neurologist evaluates you, works with your doctor to determine the most appropriate treatment and sends the treatment recommendation electronically to the spoke hospital.

Having a prompt evaluation increases the possibility that clot-dissolving therapies (thrombolytics) can be delivered in time to reduce stroke-related disability. To be effective, clot-dissolving therapies must be given within three to four and a half hours after you experience stroke symptoms.

  • Expertise and experience. Mayo Clinic neurologists have expertise and experience in evaluating and treating people who've had a stroke or have other brain and blood vessel conditions (cerebrovascular conditions). Mayo Clinic's campuses in Arizona, Florida and Minnesota, and at Mayo Clinic Health System in Eau Claire, Wis., are certified as primary stroke centers by The Joint Commission, a national organization that evaluates and accredits health care providers.
  • Team approach. At a central site, a dedicated staff of neurologists trained in blood vessel conditions (vascular neurologists), brain surgery (neurosurgeons), brain imaging (neuroradiologists) and stroke telemedicine work as a team with emergency medicine doctors and staff at remote sites.
  • Individualized care. Mayo Clinic stroke telemedicine staff gives you individualized care and serves you in your community.
  • Technology. Vascular neurologists at Mayo Clinic use several advanced technologies in stroke telemedicine, depending on the remote site's location and available resources.
  • Network growth. Doctors at Mayo Clinic in Arizona began participating in stroke telemedicine as a trial in 2007, and the stroke telemedicine network has grown since then to 11 remote sites. Staff at Mayo Clinic in Florida launched a stroke telemedicine network in 2010, and staff at Mayo Clinic in Minnesota is developing a stroke telemedicine network.
  • Research. Doctors actively study stroke and stroke telemedicine, including new technologies and other areas.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Doctors trained in neurology, neurosurgery, emergency medicine, radiology and other areas participate in stroke telemedicine at Mayo Clinic in Arizona. Doctors have conducted more than 1,500 stroke telemedicine consultations, administered clot-dissolving therapies (thrombolytics) to more than 275 people with acute stroke, and transferred more than 150 people to Mayo Clinic Hospital for further stroke treatment after telemedicine evaluation.

Doctors at Mayo Clinic in Arizona first began participating in stroke telemedicine as a trial in 2007, and established the Stroke Telemedicine for Arizona Rural Resident (STARR) network later that year. The stroke telemedicine program has since expanded to include 10 remote sites (spokes) in Arizona and one remote site outside Arizona. Doctors are actively involved in stroke telemedicine research.

For more information about stroke telemedicine at Mayo Clinic in Arizona contact 480-301-9145.

Doctors trained in vascular neurology, endovascular neurosurgery, interventional radiology, emergency medicine and other areas participate in stroke telemedicine at Mayo Clinic in Florida. Since the stroke telemedicine program began in 2010, doctors at Mayo Clinic in Florida have performed more than 290 stroke telemedicine consultations, administered clot-dissolving therapies (thrombolytics) to more than 30 people with acute stroke, and transferred more than 30 people to Mayo Clinic Hospital for further stroke treatment after telemedicine evaluation. Currently the program has one remote site (spoke), and additional spokes are in development.

For more information about stroke telemedicine at Mayo Clinic in Florida, contact 904-953-6076.

Staff at Mayo Clinic in Minnesota is currently developing a stroke telemedicine network.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic researchers actively study stroke telemedicine (telestroke) and acute stroke care.

Mayo Clinic doctors incorporate training in remote evaluation of stroke and other acute neurological conditions in some residency and fellowship programs.

Publications

Read Mayo Clinic publications at PubMed, a service of the National Library of Medicine.

Read about how a telemedicine robot delivers care at Mayo Clinic in Arizona.

Nov. 13, 2014