Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.
Telestroke is one of the most frequently used and rapidly expanding applications of telemedicine, delivering much-needed stroke expertise to hospitals and patients. This document reviews the current status of telestroke and suggests measures for ongoing quality and outcome monitoring to improve performance and to enhance delivery of care.



A literature search was undertaken to examine the current status of telestroke and relevant quality indicators. The members of the writing committee contributed to the review of specific quality and outcome measures with specific suggestions for metrics in telestroke networks. The drafts were circulated and revised by all committee members, and suggestions were discussed for consensus.



Models of telestroke and the role of telestroke in stroke systems of care are reviewed. A brief description of the science of quality monitoring and prior experience in quality measures for stroke is provided. Process measures, outcomes, tissue-type plasminogen activator use, patient and provider satisfaction, and telestroke technology are reviewed, and suggestions are provided for quality metrics. Additional topics include licensing, credentialing, training, and documentation.
Lawrence R
LR
Wechsler
Bart M
BM
Demaerschalk
Lee H
LH
Schwamm
Opeolu M
OM
Adeoye
Heinrich J
HJ
Audebert
Christopher V
CV
Fanale
David C
DC
Hess
Jennifer J
JJ
Majersik
Karin V
KV
Nystrom
Mathew J
MJ
Reeves
Wayne D
WD
Rosamond
Jeffrey A
JA
Switzer
D000572:American Heart Association; D006282:Health Personnel / Q000592:standards* / Q000639:trends; D006801:Humans; D011787:Quality of Health Care / Q000592:standards* / Q000639:trends; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017216:Telemedicine / Q000592:standards* / Q000639:trends; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D010959:Tissue Plasminogen Activator
AHA Scientific Statements; quality indicators, health care; stroke; telemedicine; treatment outcome