Telestroke services save money, improve outcomes

The use of telestroke networks may be more cost-efficient and lead to better outcomes among acute ischemic stroke patients than routine treatment at a community hospital with no such network, according to a study published in the December issue of the American Journal of Managed Care.

Researchers led by Bart M. Demaerschalk, MD, MSc, of the Mayo Clinic in Rochester, Minn., compared the costs and effectiveness of a telestroke network with one hub and seven spokes with no telestroke network using a hypothetical cohort of patients with an average age of 68. They assumed the network’s hub hospital would have an average of 400 acute ischemic stroke patients, based on data obtained from the Mayo Clinic and the Georgia Health Sciences University. They defined effectiveness as quality-adjusted life-years (QALYs).

Costs for patients in the telestroke network were $1,436 less than for patients not treated in a telestroke network. The network patients also had 0.02 more QALYs over a lifetime. However, as the number of transfers from spoke hospitals to the hub hospital increased, the network’s cost-effectiveness decreased.

The ultimate cost savings, the authors argued, justifies the initial investment in setting up the network.

“The results serve to inform government, ministries of health, politicians, legislators, health policy makers, insurers, healthcare institutions, practitioners, patients, and members of the general public that an up-front investment in telemedicine technology, connectivity, infrastructure, and stroke network personnel can be justified in our health system,” they wrote.

They also argued that insurance companies should reimburse telestroke consultations just as they do in-person consultations.

Genentech provided some funding for this research.