What Have Been Some of the Unexpected Challenges Associated with Telemedicine?

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The telestroke program actually that followed a multi year telemedicine initiative that we have staffed at our hospital and so we learnt, lessons learnt from others, there's a wonderful telestroke program out of Massachusetts General Hospital, that we modeled after ,we worked with it, it's a very collaborative community and so, our telemedicine program has been involved in the provision of care since 1996.

We have grown, our partners have grown and so it's a matter of trust between entities, between health care entities and when we decided we were ready to engage, we were with our community partners to say are you willing to do this and try it? So it's a matter of coordinating the processes between community hospitals, community providers, the academic centers, EMS as well.