title: Emergency physician and stroke specialist beliefs and expectations regarding telestroke.
abstract: OBJECTIVE
  Telestroke has been effective in the management of acute ischemic stroke. This study characterizes and compares stroke specialist (SS) and emergency physician (EP) perceptions of telestroke and identifies barriers preventing increased implementation.
  
  
  METHODS
  A survey was developed and distributed nationwide to 382 SSs through an online survey system and in paper form to 226 EPs attending the 2008 American College of Emergency Physicians national conference.
  
  
  RESULTS
  Stroke specialists perceived themselves to be more knowledgeable about telemedicine and telestroke (P<0.001 and P=0.010, respectively). A large majority of physicians in both specialties either strongly agreed or agreed that telestroke will reduce geographical differences in stroke management and that it is superior to telephone consultation. EPs perceived patient preference (P<0.001), recombinant tissue plasminogen activator side effects (P<0.001), level of technology (P=0.005), and recombinant tissue plasminogen activator not the standard of care (P<0.001) to be more significant obstacles to increased implementation of telestroke than SSs. However, SSs found increased personal work to be a greater barrier than EPs (P<0.001).
  
  
  CONCLUSIONS
  SSs and EPs report positive beliefs regarding telestroke; however, perceived obstacles exist to implementation. Differences between barriers perceived by EPs and SSs need to be addressed to enhance acute ischemic stroke treatment.
authors.forename: Ari
authors.initials: A
authors.lastname: Moskowitz
authors.forename: Yu-Feng Yvonne
authors.initials: YF
authors.lastname: Chan
authors.forename: John
authors.initials: J
authors.lastname: Bruns
authors.forename: Steven R
authors.initials: SR
authors.lastname: Levine
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002545:Brain Ischemia / Q000628:therapy*; D004635:Emergency Medicine / Q000379:methods; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D020521:Stroke / Q000175:diagnosis / Q000628:therapy; D017216:Telemedicine / Q000706:statistics & numerical data; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D000078329:Workforce
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator