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Telestroke service rolled out across regional NSW

Image Credits: NSW Government Website, Press Release

The $21.7 million telestroke service will link expert stroke clinicians with local emergency physicians to quickly determine the best possible treatment plan for a patient.

Patients at Port Macquarie and Coffs Harbour hospitals will be the first to benefit from the telestroke service, which is based at Sydney’s Prince of Wales Hospital.

The service will expand to up to 23 sites across NSW over the next three years.

A successful pilot of the service in the Hunter New England, Central Coast and Mid North Coast local health districts since 2017 have already helped 1200 patients.

In 2018-19, 13,651 people were hospitalised for a stroke in NSW. Of those, 32% were from regional, rural or remote areas.

The region’s Health Minister said the telestroke service will remove geographical barriers and improve outcomes for thousands of regional and rural stroke patients every year, giving them a much greater chance of surviving and leading a normal life.

People in regional and rural areas have a far greater risk of hospitalisation from stroke and this vital service will provide them with immediate, life-saving diagnosis and treatment from the state’s leading clinicians, the Minister stated.

What is telestroke service?

According to another health services website, telestroke is a web-based approach to treating stroke victims who have not been admitted to a hospital.

Strokes are caused by the sudden death of brain cells due to a lack of oxygen. Time is very important when treating a stroke; patients who are treated within 90 minutes of a stroke have a significantly lower risk of permanent brain damage or death.

For this reason, telestroke services are especially useful to patients in rural areas, where acute-care hospital services are often hours away.

According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled.

High blood pressure contributes to more than 12.7 million strokes worldwide. Europe averages approximately 650,000 stroke deaths each year.

In developed countries, the incidence of stroke is declining, largely due to efforts to lower blood pressure and reduce smoking. However, the overall rate of stroke remains high due to the ageing of the population.

NSW Stroke Strategy/Model of Care

The NSW government is working to develop an overarching stoke strategy for NSW. This includes reviewing and improving access to Stroke unit Care across Metropolitan and Rural NSW as well as reviewing the functionality of the Stroke Incentive funding  ‘BED 69’.

NSW Stroke Reperfusion Program (SRP)

Moreover, the government will focus on all the components that can enhance the pathways for metropolitan and rural access to reperfusion therapies.

  • Pre-notification
    • Collaboration with NSW Ambulance and the cardiac network to consider state-wide systems for pre-notification
    • Collaboration with ANSW to deploy in the field triage tool for stroke
  • Endovascular Clot Retrieval
    • The NSW government will support the MOH in progressing the establishment of an ECR AR-DRG Code Progress and in the development of State Wide Neurointerventional Service
    • Develop ECR Referral Criteria Guide to ensure all clinically appropriate patients in NSW have timely access to neuro-interventional services when required.
    • To undertake a State Stroke Reperfusion Program Economic Evaluation in collaboration with the ACI Health Economics and Evaluations Team.

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