Stroke Telemedicine for Arizona Rural Residents, the Legacy Telestroke Study

Area of Science:

• Neurology
• Telemedicine
• Health Services Research

Background:

• The efficacy of telemedicine for stroke care was initially demonstrated in the STRokE DOC trials.
• The Stroke Telemedicine for Arizona Rural Residents (STARR) network was established as Arizona's first telestroke network.
• STARR was designed as a 7-spoke, 1-hub system to serve rural, remote, and underserved populations.

Purpose of the Study:

• To establish a statewide telestroke research network in Arizona.
• To determine the feasibility of collecting, recording, and analyzing telestroke consultation data.
• To establish quality measures, track improvement, and benchmark against national and international programs.

Main Methods:

• The STARR trial enrolled patients with acute stroke symptoms within a 12-hour window from 2008-2011.
• Mayo Clinic Hospital served as the hub, providing telestroke consultations to seven rural spoke hospitals.
• A state grant funded telemedicine equipment, maintenance, and professional services.

Main Results:

• The telestroke hotline was activated 537 times, with 443 patients enrolled.
• A feasible and pragmatic approach for prospective data collection and analysis was developed.
• The STARR network benchmarked well and laid the foundation for future telestroke networks.

Conclusions:

• Rural hospitals can effectively collaborate with central centers using telemedicine for acute stroke assessment and treatment.
• This model is adaptable for managing other time-sensitive medical emergencies.
• The STARR trial demonstrated the value of a coordinated, technology-enabled approach to stroke care.