Telemedicine transforming stroke care in Piauí: an analysis of a state-wide initiative’s first year

Sep 29, 2026

A retrospective descriptive analysis evaluates 868 patients with suspected stroke who received telemedicine-based care in Piauí during the program’s first year (October 2022 to September 2023). The state-wide network includes six stroke treatment centers and uses the JOIN telemedicine platform to capture demographics, stroke type, treatment timelines, and thrombolytic outcomes. Chronic hypertension and diabetes were common, and treatment delays were quantified. Findings show improved access to essential thrombolytic therapy and reduced healthcare disparities, with future work focused on shortening times and expanding infrastructure.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusion

Introduction

Article published online: 2025-06-01 Original Article 1 Telemedicine transforming stroke care in Piauí: an analysis of a state-wide initiative’s ﬁrst year Irapuá Ferreira Ricarte 1,2 Ícaro Araújo de Sousa3 Romilto Costa Pacheco Neto4 Arthur de Oliveira Veras3 Camila Victória da Silva2 Cristina Calmon de Araújo Mascarenhas2 Matheus Felipe da Silva2 Gisele Sampaio Silva 1 Octávio Marques Pontes-Neto3 1 Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil. 2 Centro Universitário UNINOVAFAPI, Departamento de Ciências da Saúde, Teresina PI, Brazil. 3 Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil. 4 Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Ribeirão Preto SP, Brazil. Arq. Neuro-Psiquiatr. 2025;83(5):s00451807719 . Address for correspondence Icaro Araújo de Sousa (email: [icaroas@usp.br](icaroas@usp.br)) Abstract Keywords ► Stroke ► Telemedicine ► Thrombolytic Therapy ► Healthcare Disparities ► Brazil Background Prior to October 2022, stroke patients in Piaui lacked access to both stroke unit care and thrombolytic treatment, until the implementation of a telemedicine-based stroke care program. Objective To conduct a descriptive analysis of patients suspected of stroke who received telemedicine-based care in Piauí during the ﬁrst year of the program ’s implementation. Methods We conducted a retrospective analysis of 868 patients treated from October 2022 to September 2023 under the state-wide stroke care program, which includes 6 Stroke Treatment Centers distributed around the state. Utilizing data from the JOIN telemedicine platform, the analysis focused on patient demographics, stroke types, treatment timelines, and outcomes of thrombolytic treatment. Results The cohort included 868 patients, with a mean age of 67.2 years, out of whom 55.5% were male. Chronic hypertension was reported in57.8%and diabetes in22.5% of the patients. The average onset-to-door time was 3.3hours, door-to-computed tomography time was 23minutes, and door-to-needle time averaged 67minutes. Thrombolysis was administered to 15.6% of all stroke cases, with 31.8% among those being ischemic strokes. Among patients who arrived within the thrombolytic time window, the rate was 27.3% . Conclusion The introduction of a telemedicine-based stroke care program in Piauí has signiﬁcantly enhanced access to essential stroke treatments, demonstrating its effectiveness in overcoming healthcare disparities. The initiative’s success underscores the potential of telemedicine as a scalable model for improving stroke care in regions with limited healthcare resources. Future efforts will focus on reducing treatment times and expanding stroke care infrastructure to ensure comprehensive patient care. received July 28, 2024 received in its ﬁnal form January 20, 2025 accepted February 13, 2025 DOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1807719 . ISSN 0004-282X. Editor-in-Chief: Ayrton Roberto Massaro . Associate Editor: Marcos Christiano Lange . © 2025 . The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)) Thieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil 2 Telemedicine transforming stroke care in Piauí Ricarte et al. INTRODUCTION Stroke has risen to become Brazil’s leading cause of death as of 2022, with its survivors often facing severe physical and cognitive challenges tha

FAQs

What problem in Piauí led to implementing a telemedicine-based stroke care program?

Before October 2022, stroke patients in Piauí lacked access to stroke unit care and thrombolytic treatment. The program was launched statewide to address these treatment gaps and reduce delays.

How was the study conducted and what time period does it cover?

The study retrospectively analyzed 868 patients treated from October 2022 to September 2023. Patients received telemedicine-based care through six stroke treatment centers using the JOIN platform.

What outcomes did the study report about thrombolytic treatment and treatment times?

The cohort had an average onset-to-door time of 3.3 hours, door-to-CT time of 23 minutes, and door-to-needle time of 67 minutes. Thrombolysis was given in 15.6% of stroke cases, and among eligible arrivals within the thrombolytic time window the rate was 27.3%.

Sep 29, 2026

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