Implementation of telestroke network in Shizuoka prefecture

Abstract

Establishment of telestroke networks has been proposed to overcome regional disparities in stroke treatment in Japan. To identify potential demand for telestroke network and a prerequisite step for introduction, we performed geographic information system (GIS) analysis with questionnaire survey for hospitals in Shizuoka prefecture. The GIS analysis showed that 4.3% of the population lived in areas where they could not reach hospitals that are authorized to admit patients with acute stroke within 60 minutes. If 24/7 full telestroke support was introduced to the hospitals, 50–70 more patients could be treated by intravenous tissue plasminogen activator (tPA) annually. As a prerequisite step before introduction of telestroke network, 24% hospitals chose “an establishment of local transfer protocol for acute stroke patients with surgical indication” and 15% of hospitals chose “medical malpractice and liability”. This study revealed a potential demand for the telestroke network even in hospitals specialized for stroke treatment and that GIS analysis is useful for estimating the effects of introducing telestroke networks in a community.