Quality of Life After Stroke Using a Telemedicine-based Stroke Network

Approximately 750,000 patients suffer from ischemic stroke (AIS) annually in the United
States. AIS is a a leading cause of long-term disability and the third-leading cause of
mortality. Effective therapies exist to ameliorate the disability associated with AIS, but
implementation of these therapies is time-sensitive. Currently, there is a shortage in
health care professionals with expertise in the treatment of stroke and such expertise tends
to be concentrated in large community-based or academic medical centers. To respond to this
shortage, stroke networks are being organized in a "hub-and-spoke" model to facilitate the
rapid delivery of time-sensitive interventions such as intravenous (i.v.) tissue plasminogen
activator (tPA) or rapid evaluation for AIS. Some networks are also using telemedicine to
facilitate this approach and bring the needed expertise via robotic tele-presence (RTP).
Though the accuracy of stroke diagnosis and i.v. tPA utilization may be higher in RTP based
networks, the impact of this model on patient's outcomes has been difficult to elucidate. To
this end, meaningful validated outcome assessments are crucial to understand the impact of
stroke interventions including telemedicine or RTP based networks. The objective of this
study is to translate evidence-based practice of healthcare, patient-centered outcome
assessments, and patient-family perceptions of delivery of care into meaningful data. This
will aid in the validation of the role of interventions such as "hub-and-spoke" RTP based
models in stroke care.

Inclusion Criteria:

- Patients with suspected acute ischemic stroke (AIS)

- Age >17 years

Exclusion Criteria:

- Hemorrhagic strokes (ICH or SAH)

- Transient ischemic attacks (TIA)

- Trauma

- Inability to obtain informed consent

- Participation in another study