Abstract Details

Title Partners Telestroke Network: Experience of a Multistate, Multicenter Hospital Alliance in the Remote Management of Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 213

Objective

Background BACKGROUND: Telestroke systems link rural and under-resourced spoke hospitals to regional acute stroke center hubs to support regionalized acute stroke systems of care. The Partners Telestroke Network (PTN) was launched in 2002 at Massachusetts General Hospital and became a nationwide network in 2008. It now consists of five regional US hubs serving 56 spokes in 7 states.

Design/Methods DESIGN/METHODS: The PTN hubs are Partners Healthcare, MA (PHS); Yale-New Haven Hospital, CT (YNH); Swedish Medical Center-Seattle, WA (SMC); INTEGRIS Health, OK (IH) and University of Virginia Health System, VA (UVA). Data on all TeleStroke consults entered into the PTN common data portal from 01/2008-8/2012 were analyzed and 2012 rates were annualized. Hubs provided data from different epochs of time during this period (PHS: 2008-2012; YNH: 2008-1012; SMC: 2008-2010; IH: 2009-2012; UVA: 2011-2012). Values reported as median [interquartile range].

Results RESULTS: There were 2204 AIS cases evaluated from 1/2008-8/2012, quadrupling from 187 in 2008 to 760 in 2012. Hubs contributed differing numbers of cases (PHS, n=1692; YNH, n=171; SMC, n=56; IH, n=252; UVA, n=34). Comparing 2008 vs. 2012, there was an increase in the total number of spokes (22 vs. 56), the median annual TeleStroke case volume per hub (12.5 [4.8-123.0] vs. 60.75 [38.7-188.6]; p<0.001) and per spoke (5.5 [2.0-10.5] vs. 12.0 [5.6-21.4]; p<0.001). IV tPA use was similar over the study period (35.3% vs. 32.7%, p=0.35).

Conclusions CONCLUSIONS: These data demonstrate the rapid growth of a multistate, multicenter academic network of stroke centers providing increasing access to acute stroke care. This model for regionalization of stroke care is feasible and generalizable across different geography and hospital types. Further research into the clinical and cost effectiveness of these networks is warranted.

Authors/Disclosures
Lee H. Schwamm, MD, FAAN (Yale New Haven Health System) PRESENTER	Dr. Schwamm has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Prime ��ɫ��. Dr. Schwamm has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Schwamm has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for lifeimage. Dr. Schwamm has received personal compensation in the range of $500-$4,999 for serving as a Consultant for mediasphere. Dr. Schwamm has received personal compensation in the range of $500-$4,999 for serving as a Consultant for medscape/WebMD. Dr. Schwamm has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Schwamm has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Penumbra. Dr. Schwamm has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Schwamm has received research support from NINDS. The institution of Dr. Schwamm has received research support from PCORI. Dr. Schwamm has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Schwamm has received publishing royalties from a publication relating to health care. Dr. Schwamm has a non-compensated relationship as a Board of directors with American heart association that is relevant to AAN interests or activities.
Syed T. Ali, MBBS, BSc, MD (Syed T Ali MD PLLC)	No disclosure on file
Timothy L. Vollmer, MD, FAAN	The institution of Dr. Vollmer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen IDEC. The institution of Dr. Vollmer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech/Roche. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siranax. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers Squib. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela Bios. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. The institution of Dr. Vollmer has received research support from Rocky Mountain MS Center. The institution of Dr. Vollmer has received research support from Biogen. The institution of Dr. Vollmer has received research support from Actelion. The institution of Dr. Vollmer has received research support from Genentech/Roche. The institution of Dr. Vollmer has received research support from Anokion. The institution of Dr. Vollmer has received research support from TG Therapeutics.
Lawrence W. Davis, MD (Lawrence W. Davis, MD Inc)	No disclosure on file
	No disclosure on file
	No disclosure on file
Joseph L. Schindler, MD (Yale University Department of Neurology)	Dr. Schindler has received personal compensation for serving as an employee of Aeromics. Dr. Schindler has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Aeromics. Dr. Schindler has received stock or an ownership interest from Aeromics. Dr. Schindler has received publishing royalties from a publication relating to health care.
	No disclosure on file
William H. Likosky, MD, FAAN	No disclosure on file
Nina J. Solenski, MD (UVA - Neurology)	Dr. Solenski has received personal compensation in the range of $0-$499 for serving as an Expert Witness for Multiple. The institution of Dr. Solenski has received research support from HRSA . Dr. Solenski has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
	No disclosure on file

��ɫ����

��ɫ����

��ɫ��

��ɫ��