When someone in a rural town has a sudden stroke or another acute neurological emergency, getting specialist help quickly can be the difference between going home or needing lifelong care. This study looked at whether a digital hub-and-spoke telemedicine network—offering 24/7 remote expertise, standard procedures, and digital quality checks—made a difference for these patients.
The researchers compared 11 hospitals using the ANNOTeM telemedicine network with 11 similar rural hospitals that did not. They followed adults hospitalized with acute neurological disorders for 90 days. The main finding was that the combined rate of death or new need for nursing home or outpatient care was lower in the network hospitals after implementation (33.8% vs. 35.9% before, and 40.7% vs. 42.5% in control hospitals). The adjusted analysis suggested a modest benefit, with a 95% confidence interval that just included no effect.
Costs per patient in the network hospitals rose slightly, and the cost per avoided adverse outcome was about €14,968. No safety events were reported, but the study did not track them specifically. This was an observational study using claims data, so it can show an association but not prove the network caused the improvement. The findings may not apply to non-rural settings, and longer-term outcomes beyond 90 days are unknown.