Telemedicine for stroke: a systematic review.

Inequalities in stroke patient care have been demonstrated in different locations and at different times. To overcome the inequity of access to specialist stroke care, telemedicine systems have been developed to provide remote specialist assessment of patients with real-time clinical evaluation for hyperacute care and rehabilitation. An electronic database search was performed of MEDLINE, EMBASE and the Cochrane Library and extensive manual searching of articles was conducted to identify studies investigating the use of telemedicine in managing acute stroke and post-stroke rehabilitation. There were 20 observational and 2 randomized, controlled acute studies involving 15872 patients and 2 observational and 4 randomized controlled rehabilitation studies involving 112 patients that met the inclusion criteria. Telemedicine for stroke, in both acute and rehabilitation settings, was demonstrated to be safe, effective, feasible and acceptable and was shown to reduce geographical differences and increase diagnostic accuracy and uptake of thrombolytic treatment.