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April, 2017

6.1 Introduction

Telestroke modalities are a Telestroke Call Centre component of comprehensive stroke programs to enable equitable access to stroke expertise across the continuum of care and across geographic regions. An economic cost-avoidance analysis of Canadian stroke care delivery demonstrated significant savings to the healthcare system by implementing telestroke services (Krueger et al, Stroke, 2011). In Canada, there remain considerable variations in access to stroke services and in the uptake and implementation of Telestroke. Therefore, a key step for all stroke and telestroke programs is to establish an evaluation strategy during the development phase, and carry it through implementation. The data collected through evaluation should be used to inform opportunities for ongoing improvement and decision-making regarding continued and expanded investments in telestroke and program sustainability.

Evaluation strategies for telestroke should include all stages along the continuum of care and address structure, process and outcomes, as outlined in our CTAC 2013 Telestroke Framework. Within these strategic domains the following quality dimensions should be measured for each application of telestroke along the continuum of care:

  • Accessibility – extent to which patients who should get access to stroke expertise are actually receiving that access, as well as wait times, need for transfers to more advanced level of care
  • Effectiveness – the impact of access to specialized stroke services through telestroke on patient outcomes, complications, length of stay, readmissions, and recurrent stroke
  • Efficiency – cost savings, streamlining of care, timely availability of telestroke services on demand
  • System Integration and Continuity – extent to which the continuity of care for patients is preserved with the use of telestroke technology as part of their episode of care, and extent to which transitions are seamless, and follow-up care and providers clearly defined
  • Patient Experience – patients perceptions of the telestroke encounter
  • Provider Experience – healthcare provider perceptions of the telestroke encounter, their educational preparation and competency level to participate in telestroke
  • Technical efficiency and responsiveness – the extent that the technology is functioning without incident or technical difficulties that could negatively impact and of the above dimensions of quality

Table of Contents

6.1 Introduction
6.2 CTAC Core Performance Measures for Telestroke Updated
6.3 Telestroke Patient Experience Survey
6.4 Telestroke Provider Experience Survey
6.5 Telestroke data collection NEW
6.6 Telestroke Evaluation Overview Slides (Lindsay)
6.7 Stroke Cost Avoidance Including Telestroke (Krueger et al, Stroke 2011)