Abstract
The concept of telestroke networks has been proposed to overcome regional disparities in stroke treatment. Such networks do not yet operate in Japan. The geographic information system analysis demonstrated that 6.8–69.3 more patients could be treated by intravenous (IV) tPA annually, when telestroke support was introduced to the existing hospitals. These numbers exceeded the estimated annual increases of 0.8–13.7 more patients if a drip-and-ship telestroke network was introduced into an underserved area outside the 60-minute-driving time area. TPA injection by remote medical support using an interactive videoconferencing system is feasible under the current Japanese infrastructure. Current problems of cost-benefit and cost-effectiveness analysis, guideline and legal issue, establishment of multidisciplinary educational system, reimbursement for services, and licensure and credentialing in Japan were discussed.
