Table 2.
Telestroke use and the clinical care of stroke patients.
| EDa characteristics | All EDs in sample (N=378), n (%) |
EDs with telestroke only (n=106), n (%) |
EDs with telestroke and pediatric telehealth (n=214), n (%) |
EDs with pediatric telehealth only (n=58), n (%) |
||||||||
| Joint Commission certification | 117 (31.0) | 45 (42.5) | 56 (26.2) | 16 (27.6) | ||||||||
| If no Joint Commission certification, alternative stroke certification status | 59/261 (22.6) | 16/61 (26.2) | 37/158 (23.4) | 6/42 (14.3) | ||||||||
| Neurologist available in person in the ED | 63 (16.7) | 27 (25.5) | 25 (11.7) | 11 (19.0) | ||||||||
| If neurologist available in person, timing of arrival (minutes)b | ||||||||||||
|
|
0-29 | 39 (61.9) | 18 (66.7) | 14 (56.0) | 7 (63.6) | |||||||
|
|
30-59 | 16 (25.4) | 8 (29.6) | 5 (20.0) | 3 (27.3) | |||||||
|
|
≥60 | 5 (7.9) | 0 (0) | 4 (16.0) | 1 (9.1) | |||||||
| If neurologist available, is available 24/7b | 38 (60.3) | 17 (63.0) | 12 (48.0) | 9 (81.8) | ||||||||
| Approximate number of telestroke consultations in 2016 | ||||||||||||
|
|
None | 37 (9.8) | 10 (9.4) | 27 (12.6) | N/Ac | |||||||
|
|
<12 (<1/month) | 133 (35.2) | 33 (31.1) | 100 (46.7) | N/A | |||||||
|
|
12-25 (every 3-4 weeks) | 41 (10.8) | 18 (17.0) | 23 (10.7) | N/A | |||||||
|
|
26-52 (every 1-2 weeks) | 44 (11.6) | 15 (14.2) | 29 (13.6) | N/A | |||||||
|
|
>52 (>1/week) | 45 (11.9) | 22 (20.8) | 23 (10.7) | N/A | |||||||
|
|
Missing | 20 (5.3) | 8 (7.5) | 12 (5.6) | N/A | |||||||
| In 2016, was alteplase ever administered to a stroke patient in the ED without a telestroke consultation? | ||||||||||||
|
|
Yes | 94 (24.9) | 30 (28.3) | 64 (30.0) | N/A | |||||||
|
|
No | 167 (44.2) | 55 (51.9) | 112 (52.3) | N/A | |||||||
|
|
Not sure | 46 (12.2) | 16 (15.1) | 30 (14.0) | N/A | |||||||
| In 2016, approximately how many stroke patients were treated with alteplase in your ED? | ||||||||||||
|
|
0 | 29 (7.7) | 5 (4.7) | 21 (9.8) | 3 (5.0) | |||||||
|
|
1-3 | 129 (34.1) | 28 (26.4) | 83 (38.8) | 18 (31.0) | |||||||
|
|
≥4 | 172 (49.4) | 56 (52.8) | 84 (39.3) | 32 (55.2) | |||||||
|
|
Not sure | 36 (9.5) | 14 (13.2) | 20 (9.3) | 2 (3.4) | |||||||
| Patients typically admitted by hospital | ||||||||||||
|
|
Patients who experienced TIAd | 292 (77.2) | 85 (80.2) | 164 (76.6) | 43 (74.1) | |||||||
|
|
Patients who experienced stroke, without alteplase | 215 (56.9) | 64 (60.4) | 113 (52.8) | 38 (65.5) | |||||||
|
|
Patients who experienced stroke, treated with alteplase | 91 (24.1) | 36 (34.0) | 42 (19.6) | 13 (22.4) | |||||||
aED: emergency department.
bThese values are based on the number of neurologists available in person in the ED—all EDs: n=63; EDs with telestroke: n=27; EDs with both: n=25; EDs with pediatric telehealth: n=11.
cN/A: not applicable; no telestroke services.
dTIA: transient ischemic attack.