Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 2017

Abstract

Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services. While these latter areas of Telestroke application are newer, they are rapidly developing, with new opportunities that are yet unrealized. Virtual rehabilitation therapies offer patients the opportunity to participate in rehabilitation therapies, supervised by physical and occupational therapists. While not without its limitations (e.g., access to telecommunications in remote areas, fragmentation of care), the evidence-to-date sets the foundation for improving access to care and management for patients during both the acute phase and now through post stroke recovery.

Ontario Neurodegenerative Disease Research Initiative (ONDRI): Structural MRI methods & outcome measures

“…In Canada, approximately 62,000 people are treated with stroke and transient ischemic attack. In a series of publications, the Heart and Stroke Foundation Canadian Best Practice Committees have been developing various evidence-based recommendations to address issues regarding: telestroke technologies (Blacquiere et al, 2017); managing transitions of care following stroke (Cameron et al, 2016); mood, cognition, and fatigue following stroke (Eskes et al, 2015); and hyperacute stroke care (Casaubon et al, n.d.).…”

Evaluation of a pilot paediatric concussion telemedicine programme for northern communities in Manitoba

“…Over the past decade, the use of provincial telemedicine programmes has emerged as an important platform to help connect Canadians living in remote, rural and northern communities with specialised healthcare services [15][16][17][18][19]. The World Health Organisation defines telemedicine as "the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities" [20].…”

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

“…Therefore, eRehabilitation appears to be best offered in a blended intervention in which it is added to conventional rehabilitation (7,15). The 2017 Stroke Best Practice Recommendations also concluded that eRehabilitation interventions can only achieve their full potential if integrated in and added to existing stroke services delivery plans (30).…”