Despite the obvious benefits of telestroke networks, there are still some challenges that prevent it from being fully adopted. Among these are “administrative burdens and limits on reimbursement.” But there are also other reasons, such as popular misconception that telemedicine care requires expensive equipment and advanced technology systems.

The Expense Issue
First and foremost, the technology involved in a telestroke network certainly isn’t as expensive as some hospitals or care providers initially suspect. As mentioned in this week’s previous article, a telestroke system includes a “hub” of specialists that communicates with the “spokes” of the system, which are individual hospitals.

At the hub end, the only technology needed is that required to provide videoconferencing and CT scan transfers. Simply put, the specialist needs to be able to see and hear the patient clearly, and he or she also needs to acquire and view the CT scan, and that’s all.

Medical videoconferencing systems need to use encrypted transmission systems, but besides that special consideration, the videoconferencing technology required at both ends is simply a computer, monitor, echo-cancelling headphones, speakers, and a broadband Internet connection.

At the spoke end, each hospital needs a CT machine for the scans, the aforementioned videoconference setup, and the ability to transfer the scans to the hub, which is easily provided.

All of the equipment needed for a telestroke network is usually either already at a hospital, in the case of the spokes of the network, or it can easily be installed and operated at the hub. Not only is the initial capital investment relatively small, but the return on the investment, in the form of better and more affordable stroke care, is significant.

Reimbursement Issues
Medicare, it seems, is not providing coverage for stroke victims that sufficiently covers the cost of their treatment, which is causing the hospitals to lose the difference, in many situations. The result of this gap between reimbursement and costs is that fewer hospitals are able to staff a stroke treatment center. Although this difference between cost and coverage is reducing overall stroke care, it also provides a place where telemedicine has enhanced benefit as a cost-cutting measure.

Administrative Burdens
Though some more research is necessary, perceived administrative burdens with telemedicine systems tend to be a result of unfamiliarity and reluctance to adjust to change. In many ways, greater integration of digital information and more efficient long-distance communication of medical expertise can reduce administrative burdens, although there is an initial period of adjustment.

There are also some legitimate concerns about insurance coverage and liability, but these issues have been sorted out with much more experimental systems, and the results have often proven to be worthwhile.