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Explore the telestroke resource center on Activase.com

Learn more about how telestroke may help patients in rural and underserved areas and how you can establish a telestroke network using the resources provided.

Journal articles

Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. (Meyer 2008)

The STRokE DOC trial compared the effectiveness of telemedicine vs telephone modalities for decision making in acute telestroke consultations.1

Telemedicine vs Telephone Consultation in STRokE DOC

  • The authors conclude that use of telemedicine vs telephone results in more accurate diagnosis of stroke


Watch a video of the STRokE DOC technology in action and see an interview with Brett C. Meyer, MD, the principal investigator in the STRokE DOC trial.


Recommendations for the implementation of telemedicine within stroke systems of care: a policy statement from the American Heart Association. (Schwamm 2009)

The American Heart Association (AHA) discusses the use of telemedicine for stroke care and puts forth 9 general recommendations for implementation of telestroke relevant to contractual agreements, documentation, industry standards, reimbursement, and licensure. The report surveys telestroke projects in the United States and notes lessons learned from these efforts.

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Government and professional assistance organizations

Telehealth Resource Centers (TRCs)
The national TRC comprises 5 regional TRCs that work to assist healthcare organizations in the establishment of telehealth systems. Regional networks include the California Telemedicine and eHealth Center, the Great Plains Telehealth Resource and Assistance Center, the Midwest Alliance for Telehealth and Technology Resources, the Northeast Telehealth Resource Center, and the Northwest Regional Telehealth Resource Center. Though each regional TRC functions separately, a goal of the national TRC is to share experiences and best legal and regulatory practices across regions.

American Telemedicine Association (ATA)
The ATA, established in 1993, is a leading resource and advocate for promoting access to medical care via telemedicine.

Association of Telehealth Service Providers (ATSP)
The ATSP, founded in 1996, works to help telehealth become an integral part of healthcare. The ATSP is a business-oriented association that aids the healthcare community in providing and receiving payment for telehealth services.

Center for Telehealth and E-Health Law (CTeL)
The CTeL, created in 1995, serves as a resource and advocate for understanding and overcoming legal barriers to telehealth and e-health.

The Office for the Advancement of Telehealth
The Office for the Advancement of Telehealth is part of the Health Resources and Services Administration (HRSA), which is an agency of the United States Department of Health and Human Services. The HRSA promotes the use of telehealth to reach underserved people by facilitating partnerships among governmental agencies, evaluating current practices, and promoting knowledge exchange.

Telemedicine.com
Telemedicine.com is a consulting resource featuring a community discussion forum, a worldwide directory, grant information, and job, event, and conference updates.

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Nonprofit organization Web site

Universal Service Administrative Company (USAC)
The USAC provides discounted telecommunication services for eligible rural healthcare providers through the Rural Health Care Program of the Universal Service Fund. The program reimburses telecommunications and Internet service providers for services rendered to rural healthcare providers, and the discount is passed along to the program participants.

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Telestroke equipment and company Web sites

REACH CallTM
REACH Call is a Web service provider that allows neurologists affiliated with hub hospitals to use a Web browser and webcam to remotely diagnose and evaluate patients and to recommend treatment for stroke and other acute medical conditions.

InTouch Health®
InTouch Health is a provider of remote presence telehealth solutions. InTouch Health operates a remote system by using robotics technology, enabling a physician from a remote location to connect to a robot in an ICU, ED, or a patient ward.

Specialists on Call
Specialists on Call provides outsourced, cost-effective specialty physician consultations to hospital emergency departments and inpatient units via telemedicine and videoconferencing systems.

Partners TeleStroke Center
Partners TeleStroke Center is affiliated with Massachusetts General Hospital and Brigham and Women’s Hospital, and it offers 24-hour on-demand acute stroke expertise via telemedicine. Partners TeleStroke Center also provides services for joining its existing network and creating a new regional telestroke network.

Polycom®
Polycom offers a broad range of videoconferencing products and services.

Tandberg
Tandberg facilitates videoconferencing and telepresence, and has developed specialized healthcare solutions.

BF Technologies
BF Technologies offers the AccessVideoTM Telemedicine System, designed specifically for diagnostic telemedicine using Internet or wireless networks.

NeuroCallTM Inc.
NeuroCallTM Inc. offers remote neurology services and consultations to hospitals via high-speed Internet connections using videoconference technology.

Genentech is neither affiliated with nor endorses any of the above-mentioned organizations.

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Downloadable organization and company directory

List of the telestroke organizations and resources.

DOWNLOAD

Modular slide presentation on telemedicine and telestroke.

DOWNLOAD


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Reimbursement information

For information regarding reimbursement associated with telemedicine, click here.

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Indication
Activase (Alteplase) is indicated for the management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability. Treatment should only be initiated within 3 hours after the onset of stroke symptoms, and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or other diagnostic imaging method sensitive for the presence of hemorrhage (see CONTRAINDICATIONS).

Safety Information
Activase therapy in patients with AIS is contraindicated in certain situations (eg, suspicion of subarachnoid hemorrhage on pretreatment evaluation, recent (within 3 months) intracranial or intraspinal surgery, history of intracranial hemorrhage, uncontrolled hypertension at time of treatment, active internal bleeding, known bleeding diathesis (eg, current use of oral anticoagulants, administration of heparin within 48 hours of onset of stroke, platelet count <100,000) (see CONTRAINDICATIONS for full list).

The most common complication during Activase therapy is bleeding. Should serious bleeding in a critical location (intracranial, gastrointestinal, retroperitoneal, pericardial) occur, Activase therapy should be discontinued immediately. Death and permanent disability are not uncommonly reported in patients who have experienced stroke (including intracranial bleeding) and other serious bleeding episodes.

The risks of Activase therapy may be increased and should be weighed against the anticipated benefits in certain conditions. [See WARNINGS in full prescribing information].

  • Patients with severe neurological deficit (eg, NIHSS >22) at presentation. There is an increased risk of intracranial hemorrhage in these patients.
  • Patients with major early infarct signs on a computerized cranial tomography (CT) scan (eg, substantial edema, mass effect, or midline shift).

Treatment of patients with minor neurological deficit or with rapidly improving symptoms is not recommended.

Orolingual angioedema has been observed in postmarketing experience in patients treated with Activase for AIS. Patients should be monitored during and for several hours after infusion for signs of orolingual angioedema.

Please click here for full prescribing information.
Reference:
1.
Meyer BC, Raman R, Hemmen T, et al. Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol. 2008;7(9):787-795.