ArticleTelemedicine journal and e-health : the official journal of the American Telemedicine Association2018
Frequent Hub-Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network.
Article in Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Organizational Factors Determining Access to Reperfusion Therapies in Ischemic Stroke-Systematic Literature Review.International journal of environmental research and public health · 2022Pooled it
- Use, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States.Circulation · 2019Trial
- Geographic variability in contemporary utilization of PET imaging for prostate cancer: a medicare claims cohort study.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Association between tumor markers elevation and poor functional outcomes after acute ischemic stroke: a longitudinal stroke center-based study.Annals of medicine · 2024Article
- Global stroke statistics 2023: Availability of reperfusion services around the world.International journal of stroke : official journal of the International Stroke Society · 2024Review
- Analysis of Telestroke Usage in Rural Critical Access Emergency Departments.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2023Article
- Patient Travel Distance to Neurologist Visits.Neurology · 2023Article
- Single-step Optimization in Triaging Large Vessel Occlusion Strokes: Identifying Factors to Improve Door-to-groin Time for Endovascular Therapy.The western journal of emergency medicine · 2023Article
- Toward social-health integration in Sicily: description of the first hub and spoke model to improve the diagnostic therapeutic care paths for neurorehabilitation.Frontiers in public health · 2023Article
- Telehealth in emergency medicine: A consensus conference to map the intersection of telehealth and emergency medicine.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021Article
- Use of a Smartphone Application to Speed Up Interhospital Transfer of Acute Ischemic Stroke Patients for Thrombectomy.Frontiers in neurology · 2021Article
- The Need for Structured Strategies to Improve Stroke Care in a Rural Telestroke Network in Northern New South Wales, Australia: An Observational Study.Frontiers in neurology · 2021Article
- Trends in Telestroke Care Delivery: A 15-Year Experience of an Academic Hub and Its Network of Spokes.Circulation. Cardiovascular quality and outcomes · 2020Article
- Frequency of early rapid improvement in stroke severity during interfacility transfer.Neurology. Clinical practice · 2019Article
- Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients.BMC neurology · 2018Article
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7 authors.
Funding
Abstract
backgroundFor acute ischemic stroke patients, shorter time to thrombolytic (tissue plasminogen activator [tPA]) is associated with improved outcomes.
introductionTelestroke increases tPA use at spoke hospitals, yet its effect on door-to-needle (DTN) times for tPA administration is unknown. We hypothesize that spoke hospitals with more frequent contact to a hub hospital will have shorter DTN times than those with less frequent contact. MATERIALS AND
methodsWe identified 375 patients treated with tPA by conventional or telestroke methods in an academic hub-and-spoke telestroke network for whom date and time data were available. Strength of the spoke-hub connection was the primary predictor variable, defined as the number of all telestroke consults (tPA and non-tPA) done at each spoke hospital during the year of the patient's presentation. Patient-level regression analyses examined the relationship between DTN time and spoke-hub connection during the year of the patient's presentation, controlling for temporal trends and clustering within hospitals.
resultsSixteen spoke hospitals contributed data on 375 tPA-treated patients from 2006-2015. Hospitals treated a median of 13.5 patients with tPA per year; median hospital-level DTN was 78.8 min (interquartile range [IQR] 71.3-85). Median number of telestroke consults per year was 34 (range 3-137). Among all 375 patients, median DTN was 76 min (IQR 60-97). Strength of spoke-hub connection was significantly associated with faster DTN time for patients (1.3 min gain per 10 additional consults, p = 0.048).
conclusionsMore frequent contact between a telestroke spoke and its hub was associated with faster tPA delivery for patients, even after accounting for secular trends in DTN improvements.
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