Introduction
Patients in regional NSW experience inequitable access to specialist stroke care compared to metropolitan areas. This project examines the feasibility and acceptance of implementing a TeleMDT with stroke specialist neurologist support in regional NSW, utilising existing resources.
Methods
One pilot site was recruited following initial NSW Telestroke service implementation. Patient and clinician data was collected via survey, with diagnosis, medication, and investigation changes captured through a stroke data base system. Clinician survey respondents included occupational therapists, physiotherapists, speech pathologists, basic physician trainees, medical consultants, and nurses. Patients with high clinical acuity who could meaningfully engage in virtual consultation were surveyed.
Results
Data was collected over three months (March-June 2025). During this period, 33 patients were discussed in the TeleMDT meetings resulting in 8 diagnosis changes (24%) and 7 medication changes (21%), demonstrating tangible clinical impact. Only one investigation change was made. Eleven clinicians responded via survey, with 100% agreeing that access to the stroke specialist neurologist increased evidence-based treatment decisions, provided clinically valuable input, and was effective in virtual format. Five patient surveys were collected. All patients (100%) were aware their case was discussed in the TeleMDT with stroke specialist contribution and were satisfied with information provided about diagnosis, medications, and investigation results.
Conclusion
A TeleMDT incorporating stroke specialist neurologist support, building on existing resources to support equitable stroke care in regional NSW, is feasible and beneficial to both patients and clinicians.
Relevance to Clinical Relevance
This pilot project provides evidence that TeleMDT can effectively address stroke care inequities in regional NSW by leveraging existing resources to deliver specialised multidisciplinary care remotely.