title: Telestroke: a multi-site, emergency-based telemedicine service in Ontario.
abstract: A telestroke service was established in Ontario in 2002. Six neurologists on four campuses of two academic health centres of the University of Toronto participated in the call roster to support emergency physicians in two northern cities, North Bay and Sudbury. Videoconferencing units were provided in the hospitals and in the homes of the neurologists. PC workstations were used to access computed tomography (CT) images. In the first 34 months' operation, a total of 88 patient consultations were conducted. Twenty-six patients received tissue plasminogen activator (t-PA). Although the number of consultations was relatively low, the feasibility of telemedicine for acute stroke care was demonstrated. The economics remain to be explored. The telestroke model is a viable alternative to the provision of acute stroke care for communities that have CT scanners, but no access to a resident neurologist.
authors.affiliation: NORTH Network, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. kwaite@northnetwork.com
authors.forename: Karen
authors.initials: K
authors.lastname: Waite
authors.forename: Frank
authors.initials: F
authors.lastname: Silver
authors.forename: Cheryl
authors.initials: C
authors.lastname: Jaigobin
authors.forename: Sandra
authors.initials: S
authors.lastname: Black
authors.forename: Liesly
authors.initials: L
authors.lastname: Lee
authors.forename: Brian
authors.initials: B
authors.lastname: Murray
authors.forename: Peter
authors.initials: P
authors.lastname: Danyliuk
authors.forename: Edward M
authors.initials: EM
authors.lastname: Brown
mesh_terms: D004632:Emergency Medical Services / Q000379:methods* / Q000458:organization & administration; D005240:Feasibility Studies; D006801:Humans; D009864:Ontario; D011859:Radiography; D019114:Remote Consultation / Q000379:methods* / Q000458:organization & administration; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D019112:Teleradiology / Q000379:methods* / Q000458:organization & administration; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D049269:Videoconferencing
chemical_list: D010959:Tissue Plasminogen Activator