Telestroke and Telepathology

Came across a recent article on stroke telemedicine, or "telestroke".

Stroke telemedicine is a lifesaving practice that deserves further advancement, Mayo researchers write in the January 2009 issue of Mayo Clinic Proceedings. Since its inception, stroke telemedicine has developed nationally and internationally as a reliable means of aiding patients. Yet certain key systematic components need to be developed more fully while specific unsettled issues must be resolved.

In nearly every subspecialty's "tele-" equivalent there always seem to be the same barriers to entry and suggestions made to improve the technology for practical clinical use.

In the article the investigators make several claims — in every instance if you subsitute "telepathology" for "telestroke" and refer to pathology (histopathology) rather than stroke specifically, the claims and problems are the same for the same reasons and will likely so remain that way for sometime.

Perhaps with the new administration's goals for healthcar, healthcare IT and digitizing of medical care, some of these issues will no longer be obstacles for widespread adoption given the data to date.

"The implementation of telemedicine for stroke is a vital piece to the puzzle of creating universal access to emergency care for all patients with stroke, regardless of geographic location or hospital resources."

“Well-designed studies have shown that this consultative modality is valid, accurate and reliable.  Numerous telestroke networks exist worldwide, and most of these networks have published their implementation experiences and early outcome results.”

“Successfully delivered promises of telestroke include remote instant expert stroke diagnoses, delivery of short-term therapies, and secondary prevention advice.”

“Promises of telestroke applications that have been slower to materialize include widespread national and international telestroke networks that offer standardized evidence-based care, telestroke research networks for testing new stroke therapies, standardized measurements of telestroke quality of care, and acceptable guidelines for telestroke practice. “The long-term sustainability and growth of telestroke practice remains threatened by unresolved legal, economic and market factors.”

These factors include medical liability regulation and state licensing, substantial capital investment requirements and profit or self-sustaining plans relating to private and insurance payers.

“Telestroke practitioners and investigators should focus attention on analyzing and solving the business issues of the practice to allow further advances in the telestroke field and longevity of telestroke practice.”