Fast treatment can reduce patient harm from strokes, which kill up to 1.9 million brain cells a minute. New research will use data from the Western Australia (WA) Acute TeleStroke Service to explore the effectiveness and cost-effectiveness of telehealth consultations for regional acute stroke patients.
Digital Health CRC PhD candidate Christina Tsou and Digital Health CRC FREDs Professor Suzanne Robinson and Professor James Boyd are all part of the research team, whose most recent publication, Effectiveness and cost-effectiveness of TeleStroke consultations to support the care of patients who had a stroke presenting to regional emergency departments in Western Australia: an economic evaluation case study protocol, appeared in BMJ Open in January (Vol 11 Issue 1 2021).
“This industry-based research project has been a fantastic opportunity for research and evaluation to work alongside program implementation,” said Ms Tsou.
She says the project allows the research to be industry-relevant while supporting a service that can improve equity of access to life-changing health care for rural Western Australians.
“Participation in the variety of activities offered through DHCRC have broadened the horizon of considerations in this research and fast-tracked my thinking in telehealth, by placing it in the contemporary digital health context,” she added.
Over their lifetime, one in four people will experience a stroke – where a blocked or burst artery stops blood getting to their brain – leading to significant and often permanent impairments to physical and mental functions.
Regional Australian residents are 19 per cent more likely to experience stroke than urban-dwellers and have higher rates of stroke-related death and disability.
For some stroke patients, gaining rapid access to clot-busting medication and removal of a clot from blood vessels in the brain (clot retrieval) can mean reduced damage to their brain tissue, and this can lower the subsequent functional impairments caused by a stroke.
But this treatment can only be provided on the advice of a specialist stroke consultant, and because most stroke specialists are based in urban areas, regional patients have more limited access to timely specialist treatment and care.
The WA Acute TeleStroke Service was established in 2016 by the WA Department of Health Stroke Service Program in partnership with metropolitan stroke specialists and the WA Country Health Service (WACHS) to improve timely access to specialist stroke care for country West Australians.
Since the service began, many WACHS sites have embedded telehealth into their acute stroke pathways, supporting regional clinicians treating a stroke patient (for example, in a regional hospital emergency department) to access timely metropolitan-based stroke specialist advice via telehealth (either by videoconferencing or telephone).
According to the State’s Acute Stroke audit data, over 50 per cent of patients presenting to WACHS regional centres participating in the audit received treatment that involved a stroke consultant advising local clinicians via TeleStroke.
The paper explains the methods and rationale for a large economic evaluation which will analyse data from the WA program to find out the effectiveness and cost-effectiveness of stroke specialist telehealth consultations that occurred in around 120 rural and remote sites, including eight sites with CT scanning capability.