Abstract Details

Title Evaluation of the Impact of Telemedicine on Access to Stroke Care in Oregon

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 246

Objective

Background BACKGROUND: Telemedicine has been used to increase access to stroke care, this paper evaluates the extent of telemedicine impact in Oregon.

Design/Methods DESIGN/METHODS: Hospitals in Oregon were identified via "The Joint Commission" database. Hospitals were contacted by phone and asked questions regarding stroke center certification and stroke telemedical use using a semi-structured interview. We calculated access to stroke care by summing the population able to arrive at a facility with stroke care within 60 minutes by ground EMS. Geographies are described as having access to in-person stroke care, telemedical care, both, or neither. Population density, uninsured population, and household demographic data were obtained from the area resource file. Statistical analyses were performed using Student's T-test for continuous variables.

Results RESULTS: We obtained data from 51/57 hospitals (89% response rate). Overall, 43% of the population had in-person access to stroke care, 76% had telemedical access to care, 40% had access to both, and 20% had no access to stroke care. In-person care was available in more densely populated areas as compared to telemedical care (858.9 pop/sq. mi. vs. 184.8 pop/sq. mi., p < 0.05). In areas without in-person stroke center access, telemedical stroke care was more common in areas with lower rates of uninsured (19.6% vs. 22.5%, p < 0.05) and areas with smaller populations of adults >65 years old (16.4% vs. 19.3%, p < 0.05). However, there were no significant differences in poverty rates, median household income, or Hispanic population, and no meaningful differences in black population (0.4% vs. 0.7%, p < 0.05).

Conclusions CONCLUSIONS: Telemedicine in Oregon has substantially improved access to stroke care. In-person stroke care is clustered in urban areas. While telemedical stroke is also available in these areas, it extends coverage to less populated areas with low rates of uninsured.

Authors/Disclosures
Logan McDaneld, MD, FAAN (St. Mary's Neurology Clinic) PRESENTER	No disclosure on file
Catherine Wolff	No disclosure on file
	No disclosure on file
Philippe Gailloud, MD (The Johns Hopkins Hospital)	Dr. Gailloud has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cerenovus. Dr. Gailloud has received stock or an ownership interest from ArtVentive. The institution of Dr. Gailloud has received research support from Siemens Medical.
	No disclosure on file
	No disclosure on file
Helmi L. Lutsep, MD, FAAN (Oregon Health & Science University)	Dr. Lutsep has received personal compensation in the range of $0-$499 for serving as a Consultant for Abbott. Dr. Lutsep has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. Dr. Lutsep has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Coherex Medical. Dr. Lutsep has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/Mayo Cinic. Dr. Lutsep has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medscape Neurology.
	No disclosure on file

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