Telestroke for the Newly Minted Vascular Neurologist
The geographic proximity to a primary stroke center is highly variable and region dependent.1 Telestroke represents 1 approach in the treatment of stroke that holds promise to overcome the barrier of patient access to expert stroke care in areas underserved by neurologists and to increase utilization of efficacious thrombolytic therapies.2,3 At our institution, we have witnessed multiple fellows who graduate from our Vascular Neurology and Neurocritical Care Fellowships apply the principles acquired during their training to develop and implement a telestroke program at the institution where they join as junior faculty. Newly minted vascular neurologists may find the following approaches helpful.
The start-up and implementation of a new telestroke program can seem daunting. One of the first steps should be to obtain support from hospital leadership for building your program in the form of resources and financial support given the relatively high start-up cost. As a foundation, endorsement of the initiative should be acquired from the hospital departments that are most deeply invested in offering such a program including the Departments of Neurology, Radiology, and Neurosurgery, and less often Anesthesia, Emergency Medicine, or others. When negotiating hospital support it may be useful to emphasize that the start-up costs can be offset by fee-for-service contracts with the spokes, revenue from transfers of patients who require a higher level of care, and yearly cost savings within the network. Additional funding can also be obtained in the form of grants at the federal (eg, USDA or NIH), state, or foundation levels to supplement the budget. Once approval and interest have been identified, the communication of the goals and objectives of the telestroke program with the hospital president or their designee is essential for ensuring alignment with the hospital’s broader initiatives. Obtaining the support of these individuals will be especially …