Abstract TP018: Statewide Digital Health Transformation: Outcomes of the UAMS IDHI Telestroke Program in Arkansas

Background: Arkansas has one of the highest stroke mortality rates in the United States, driven by rural–urban disparities in access to timely interventions. The UAMS Institute for Digital Health&Innovation (IDHI) Telestroke Program was developed to provide 24/7 Vascular Neurology and Neurosurgery expertise via a hub-and-spoke network. Integration of spoke-site nursing facilitators, hub-site stroke coordinator teams and formal program evaluation enables continuous performance monitoring and targeted quality improvement. Methods: We retrospectively analyzed prospectively collected telestroke consult data from 2015–2024. Key measures included consult volume, intravenous thrombolytic (lytic) use, door-to-needle (DTN) times, and patient outcomes. Linear trend projections estimated metrics through 2027. Results: From 2015 to 2024, consult volume increased 164% (809 to 2,140), lytic-treated patients rose from 238 to 775 (>3-fold), and those receiving lytics within 60 minutes increased from 59 to 526. Median DTN times improved from 120 minutes at program inception to 50 minutes in 2024. The proportion of lytic-treated patients achieving DTN ≤60 minutes improved from 25% to 68%, with projections approaching 95% by 2027. Mortality remains low at 3.4%, with 62% of patients discharged home. Conclusions: The UAMS IDHI Telestroke Program has significantly improved acute stroke treatment access, efficiency, and outcomes in a high-burden rural state. Analytics-driven program evaluation has enabled sustained performance gains and equitable care delivery, offering a scalable model for other underserved regions.