Definitions

Overview

There is considerable variation in the literature and in practice regarding the terminology used to describe Telemedicine and Telestroke services. For the purposes of the information contained throughout the CTAC Telestroke Implementation Toolkit, the following definitions have been accepted and operationalized.

• Telehealth is the use of information and communication technology to deliver health services, expertise and information over distance. It includes telephone, internet or web-based e-health and video-based applications, and can be delivered real-time (live) or through store-and-forward (record now, view later) mode.
• Telemedicine is the provision of medical expertise for the purpose of diagnosis and patient care by means of telecommunications and information technology where the patient and the provider are separated by distance. Telemedicine may include, but is not limited to, the provision of pathology, medical imaging and patient consultative services (Federation of Medical Regulatory Authorities of Canada). Sometimes telehealth may be used synonymously; however, for this document we use telemedicine, reserving Telehealth to refer to the broader general concept of using technology in healthcare.

• Telestroke is the use of telecommunication technology to link referring and consulting healthcare sites together for real-time two-way assessment and management of stroke patients. Presently, it is used primarily to extend access to thrombolytic treatment in healthcare facilities that do not have 24/7 on-site stroke expertise. However, Telestroke is also a mechanism for increasing access to stroke expertise and education for secondary prevention, rehabilitation, and recovery.
• Referring site is the site where the patient is physically located.
• Consulting site is the site providing the stroke expertise to support the referring site in diagnosis and treatment.
• Telestroke Network is a formally organized and continuously available integrated group of healthcare facilities that includes at least one comprehensive stroke care centre. The Telestroke Network has appropriate telecommunication infrastructure for real time audiovisual communication and rapid transmission of radiological images between referring and consulting sites.
• On-Demand Telestroke is defined as an unplanned, often urgent, Telestroke consultation. Access to unplanned Telestroke services requires 24 hour per day, 7 days per week access, and usually is situated within the emergency department, but can occur elsewhere.