Mobile Telestroke During Ambulance Transport Is Feasible in a Rural EMS Setting: The iTREAT Study

Area of Science:

• Medical Technology
• Emergency Medicine
• Telecommunications

Background:

• Telestroke improves access to neurological expertise, addressing geographic disparities in acute stroke care.
• Mobile telestroke assessment during ambulance transport is proposed as a feasible solution using accessible technology.

Purpose of the Study:

• To evaluate the feasibility of a mobile telestroke platform for real-time assessment during ambulance transport.
• To assess audiovisual quality and connectivity duration of the mobile telemedicine system.

Main Methods:

• A tablet-based endpoint, high-speed modem, and antennae were integrated into an ambulance system.
• Connectivity and audiovisual (AV) quality were tested along rural ambulance routes using a 6-point rating scale.
• The goal was to achieve at least 9 minutes of continuous AV connectivity.

Main Results:

• 93% of 30 test runs achieved over 9 minutes of continuous video transmission, with a mean of 18 minutes.
• Mean video quality rating was 4.51 and audio quality rating was 5.00.
• The system's initial cost was $1,650 per ambulance.

Conclusions:

• High-quality, continuous video transmission was maintained using a low-cost mobile telemedicine platform in ambulances.
• The portable and adaptable system shows promise for prehospital diagnosis in emergency conditions.
• Mobile telestroke assessment is feasible with low-cost components and commercial wireless connectivity, though further clinical validation is needed.