TeleStroke

Table of Contents

1. Introduction, history of telehealth and telestroke2. Practical Telestroke: Setting up a Practice (inpatient and outpatient/prehospital setting, sophisticated advancement in the field, seamless delivery)3. Use of telestroke across all aspects of patient care (increase use of thrombolytic therapy, endovascular therapy, inpatient management, rehabilitation, discuss reliability, validity, efficacy within each area)4. Hyperacute management: 1. Is the patient likely having an acute ischemic stroke? 2. Is a large vessel occlusion (LVO) present / Is the patient a candidate for mechanical thrombectomy? 3. Would the patient benefit from transfer to a higher level of care?5. Telestroke Examination High Yield Pearls6. Barriers, legal issues, Limitations (state policies, Medicare/federal policies, reimbursement)7. Current Technologies (HIPAA compliance, AR/AI, remote monitoring, virtual ophthalmology)8. Telestroke in Uncommon situations: pediatric stroke, pregnancy

Authors

Latisha Katie Sharma Associate Professor of Neurology, Associate Director, UCLA Comprehensive Stroke Center; Director, Stroke Center Medical Quality; Director, TeleStroke Program, Associate Director, Vascular Neurology Residency Program. Dr. Sharma is an Associate Professor of Neurology at UCLA and holds program appointments as Associate Director of the UCLA Comprehensive Stroke Center, Stroke Center Quality Director, Director of the UCLA TeleStroke Program and Associate Director of the Vascular Neurology Residency Program. Dr. Sharma attended medical school and completed her neurology residency at Indiana University. She did her medical internship at Temple University in Philadelphia. Dr. Sharma completed her Vascular Neurology fellowship at the University of California, Los Angeles. Dr. Sharma has extensive experience in developing novel technologies for stroke care. As a fellow, she was awarded the AAN Clinical Research Fellowship Award to further her research in Hyperdynamic Therapy in Acute Ischemic Stroke. As Director of the UCLA TeleStroke program, she established and reinforced UCLA's relationships with several Los Angeles County and California hospitals to provide teleconsultations for TIA and stroke patients. Dr. Sharma serves as an advisor to the UCLA Mobile Stroke Unit. Dr. Sharma also led a UCLA NIH-SPOTRIAS study to determine whether mobile cellphone video technology can be used as a tool to assess stroke-related neurologic deficits and she has also led a study on the use of wearable technology in remote evaluation of stroke patients. Dr. Sharma served as local principal investigator for the NIH-NINDS Ethnic/Racial Variations of Intracerebral Hemorrhage Study (ERICH) and Insulin Resistance Intervention After Stroke Trial (IRIS). Dr. Sharma was the PI of the AHA Bugher Award Foundation funded REM-PROTECT trial. This is a study of ischemic preconditioning in small vessel ischemic disease. Dr. Sharma is the site PI for the NIH Stroke-Net Statins Use in Intracerebral Hemorrhage Patients (SATURN) trial. Dr. Sharma's research interests are in telemedicine and novel telehealth technologies, ischemic preconditioning and stroke prevention.