title: Remote care of a patient with stroke in rural Trinidad: use of telemedicine to optimise global neurological care.
abstract: We report a patient driven home care system that successfully assisted 24/7 with the management of a 68-year-old woman after a stroke-a global illness. The patient's caregiver and physician used computer devices, smartphones and internet access for information exchange. Patient, caregiver, family and physician satisfaction, coupled with outcome and cost were indictors of quality of care. The novelty of this basic model of teleneurology is characterised by implementing a patient/caregiver driven system designed to improve access to cost-efficient neurological care, which has potential for use in primary, secondary and tertiary levels of healthcare in rural and underserved regions of the world. We suggest involvement of healthcare stakeholders in teleneurology to address this global problem of limited access to neurological care. This model can facilitate the management of neurological diseases, impact on outcome, reduce frequency of consultations and hospitalisations, facilitate teaching of healthcare workers and promote research.
authors.affiliation: Department of Medicine, Neurology Unit, San Fernando Teaching Hospital, San Fernando, Trinidad and Tobago.
authors.forename: Antonio Jose
authors.identifier: http://orcid.org/0000-0002-8000-4655
authors.initials: AJ
authors.lastname: Reyes
authors.affiliation: Department of Medicine, San Fernando Teaching Hospital, San Fernando, Trinidad and Tobago Department of Medicine, Surgi-Med Clinic, San Fenando, Trinidad and Tobago.
authors.forename: Kanterpersad
authors.identifier: http://orcid.org/0000-0003-2937-6362
authors.initials: K
authors.lastname: Ramcharan
mesh_terms: D000368:Aged; D019468:Disease Management; D005260:Female; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D009462:Neurology / Q000379:methods*; D019035:Rural Health Services; D012424:Rural Population; D020521:Stroke / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D014300:Trinidad and Tobago