Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Impact of an outpatient telestroke clinic rural network: a 6-year experience. (122626)

Octavio Garcia Silva 1 , Luis Mena Romo 2 , Heidi Janssen 3 , Golam Hasnain 2 4 , Dante Dangelo-Kemp 5 , Rachel Peake 6 , Jaclyn Birnie 7 , Emma McCartney 8 , Priya Jacob 8 , Beng Lim Alvin Chew 1 , Simone Owen 3 , Thomas Ottavi 1 , Chehakprit Kaur 4 , Kevin Yu Chen Hou 9 , Christopher Levi 1 2 4 , Mark Parsons 1 2 4 10 11 12 , Neil Spratt 1 2 4 , Carlos Garcia‐Esperon 1 2 4
  1. Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia
  2. Hunter Medical Research Institute, Newcastle, NSW, Australia
  3. Hunter Stroke Service, Hunter New England Local Health District, Newcastle, NSW, Australia
  4. Faculty of Medicine, University of Newcastle, Newcastle, NSW, Australia
  5. University of New South Wales, Sydney, NSW, Australia
  6. Tamworth Hospital, Hunter New England Local Health District, Newcastle, NSW, Australia
  7. Armidale Hospital, Hunter New England Local Health District, Newcastle, NSW, Australia
  8. Manning Base Hospital, Hunter New England Local Health District, Newcastle, NSW, Australia
  9. Sydney Medical School, Nepean Hospital, Sydney, NSW, Australia
  10. Department of Neurology and Neurophysiology, Liverpool Hospital, Liverpool, NSW, Australia
  11. Sydney Brain Centre, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  12. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia

Background: Without appropriate intervention and management, 10-20% of stroke patients suffer a recurrent event at twelve months. Timely access to specialised stroke review in rural Australia is limited. The John Hunter Hospital stroke team partnered with rural stroke teams to develop and implement a “hybrid” model of care, a telestroke outpatient clinic comprised of both virtual care from a Newcastle-based stroke neurologist to a rural outpatient setting, and where there is local support from the stroke coordinator. We aim to describe the interventions performed on patient care across the rural network. 

Methods: Intervention data (change in diagnosis, medications, request of complementary tests or referral to trials) were recorded for consecutive patients assessed at the rural telestroke clinics (Manning, Tamworth, Armidale, and Moree Hospitals), from its establishment in November 2018, until November 2024. 

Results: A total of 709 patients were booked in the clinics. Of them, 488 (69%) were first appointments, 150(21%) were follow ups and 71(10%) did not attend. Any intervention in patient management was made in 407 patients of the 488 first appointments (83%); diagnosis was changed in 93 patients (19%), medication was modified in 203 (42%), complementary tests requested on 270 (55%) and referral to a clinical trial occurred in 62 patients (13%).  

Conclusion:  The telestroke clinic had a high attendance rate and led to a high volume of changes in management in rural stroke patients. This model of care successfully provides stroke services to rural centres without local stroke expertise.