The Role of Videoconferencing Teleconsultation in Improving Transfer Efficiency and Functional Outcomes in Rural Stroke Care: Retrospective Cohort Study.
Wang C, Chen Y, et al. • JMIR mHealth and uHealth • 2026
Videoconferencing teleconsultation was associated with improved transfer efficiency and higher use of reperfusion therapies and was potentially associated with better functional outcomes in rural acute ischemic stroke patients requiring interhospital transfer.
Key Findings
Results
Teleconsultation was associated with a significant reduction in door-in-door-out time compared to standard referral process.
Mean door-in-door-out time was 95.2 minutes (SD 22.9) in the teleconsultation group versus 132.3 minutes (SD 41.5) in the standard referral process group (P<.001)
The reduction was driven primarily by shortening of computed tomography angiography-to-ambulance notification time (mean 44.6, SD 17.4 vs 79.5, SD 37.6 minutes; P<.001)
Study included 83 patients: 41 (49.4%) in teleconsultation group and 42 (50.6%) in standard referral process group
Baseline characteristics were comparable between groups
Results
Patients in the teleconsultation group had higher rates of intravenous thrombolysis at the primary stroke center.
IV thrombolysis rate was 63.4% (26/41) in the teleconsultation group versus 40.5% (17/42) in the standard referral process group (P=.04)
In the standard referral process, clinical evaluation and thrombolysis decisions were made primarily by PSC emergency physicians via telephone-based consultation
In the teleconsultation model, videoconferencing enabled direct visual clinical evaluation between PSC and CSC physicians
Results
Patients in the teleconsultation group had higher endovascular thrombectomy rates and shorter door-to-puncture times at the comprehensive stroke center.
EVT rate was 34.1% (14/41) in the teleconsultation group versus 14.3% (6/42) in the standard referral process group (P=.03)
Door-to-puncture time was significantly shorter in the teleconsultation group (mean 83.0, SD 35.5 vs 118.5, SD 25.9 minutes; P=.04)
Both reperfusion therapy metrics favored the teleconsultation model
Results
Teleconsultation was associated with a greater shift toward better 90-day functional outcomes as measured by modified Rankin Scale shift analysis.
65.9% (27/41) of teleconsultation patients demonstrated a shift toward better functional outcomes at 90 days (odds ratio 4.55, 95% CI 1.96-11.11; P<.001)
31.0% (13/42) of standard referral process patients demonstrated a similar shift (odds ratio 1.35, 95% CI 0.63-2.94; P=.07)
Functional outcomes were assessed via modified Rankin Scale shift analysis at 90 days
Results
Safety outcomes including all-cause mortality within 90 days and symptomatic intracranial hemorrhage were comparable between groups.
No statistically significant differences in safety outcomes were observed between the teleconsultation and standard referral process groups
Safety outcomes assessed included all-cause mortality within 90 days and symptomatic intracranial hemorrhage after intravenous thrombolysis and/or EVT
The comparable safety profile suggests the teleconsultation model did not introduce additional harm
Methods
The study was a retrospective cohort study of AIS patients requiring interhospital transfer in a hub-and-spoke model conducted over a three-year period.
Patients were enrolled between January 2022 and December 2024 from a primary stroke center transferring to a comprehensive stroke center
Inclusion criteria required patients to be identified as potential candidates for endovascular thrombectomy
Group allocation was determined via institutional workflow, not randomization
Mean patient age was 73.3 years (SD 12.9)
What This Means
This research suggests that using video calls to connect doctors at rural hospitals with specialists at stroke centers can meaningfully speed up care for stroke patients who need to be transferred. In this study from Taiwan, stroke patients whose transfer was coordinated through videoconferencing received faster preparation for transfer (about 37 minutes faster on average), were more likely to receive clot-dissolving medication before transfer, and were more likely to undergo a procedure to physically remove the clot at the receiving hospital. The key bottleneck that video calls helped resolve was the time between getting a brain scan and notifying the ambulance team — a step that was nearly 35 minutes faster when specialists could visually assess patients in real time rather than relying on telephone descriptions alone.
The functional benefits were also notable. About 66% of patients in the video teleconsultation group showed improvement in their ability to function independently at 90 days, compared to 31% in the standard phone-referral group. The video consultation approach did not appear to cause any additional harm — rates of bleeding complications and deaths within 90 days were similar between the two groups.
This research suggests that videoconferencing-based teleconsultation may be a practical and effective way to improve stroke care in rural areas where patients must be transferred to larger hospitals for advanced treatment. The model could help rural hospitals and urban stroke centers coordinate more effectively without requiring additional on-site specialist staffing. The authors note that the study was retrospective and involved a single hub-and-spoke network, so larger, multi-center studies are needed to confirm these findings and explore whether the approach works for a broader range of stroke patients.
Wang C, Chen Y, Lin T, Huang H, Tu P, Chen P, et al.. (2026). The Role of Videoconferencing Teleconsultation in Improving Transfer Efficiency and Functional Outcomes in Rural Stroke Care: Retrospective Cohort Study.. JMIR mHealth and uHealth. https://doi.org/10.2196/86436