This implementation study examined and profiled policies in four states aimed at developing primary stroke centers.
States’ primary stroke center policies vary. Inter-institutional coordination between emergency response and acute care facilities is challenging. It is also essential as are policy champions who straddle clinical and policy areas. Stroke care is a developing health science. Updating accreditation standards to reflect current science needs to be fluid, and financial resources to oversee designated primary stroke centers is inadequate. Telemedicine is the most promising strategy for optimal stroke care in rural areas