German telestroke project improves care for rural patients

The ten-year experience of a German telestroke program showed that such units can provide sustained high-quality care in rural areas, according to a study published in Stroke.

The TeleMedical Project for integrative Stroke Care (TEMPiS) was established in 2003 to improve stroke prognosis for rural patients living in southeast Germany.

Researchers examined the effects of the project by looking at official hospital reports and prospective registries from 2003 to 2012 that described processes and outcomes of consecutive patients with stroke and transient ischemic attack treated in TEMPiS hospitals. Rates and timeliness of intravenous thrombolysis as well as data on teleconsultations and secondary interhospital transfers all were analyzed.

TEMPiS implementation increased the number of patients with stroke and transient ischemic attack treated in hospitals with telestroke units substantially from 19 percent to 78 percent. Intravenous thrombolysis was applied 3,331 stroke cases with proportions increasing from 2.6 percent to 15.5 percent of all patients with ischemic stroke, according to the study.

“TEMPiS is an example of how the challenges of area-wide implementation of stroke units in rural areas can be met. Although network structures have to be adapted to regional features, for example, population densities, geographical and administrative borders, and hospital infrastructures, we think that many of the experiences gained in the TEMPiS concept might be used as a role model for other rural areas,” concluded the authors.

Read the full study here.