Background and Aims: In 2014 we piloted international telestroke between New Zealand and Scotland; the service was not sustained in part due to regulatory challenges. Now we aimed to assess if de novo telestroke clinician appointment across international boundaries between Australia and New Zealand is feasible and sustainable from a regulatory, legal, technical, and service perspective.
Methods: On July 25th 2022, the Victorian Telemedicine Service initiated recruiting a New Zealand based neurologist without prior Australian work experience, registration, or residence. Regulatory approval was pursued, and multiple barriers overcome. We describe the process and outcome.
Results: It took nearly 12 months for the overseas based neurologist to get registered in Australia, complicated by her having never lived or worked in Australia. Contractual agreements were held up for a further 6 months because multiple private medical indemnity providers refused to provide cover. Technical barriers included workflow tools not being licensed in New Zealand. Eventually, all requirements were met, two training sessions occurred (one physically in Australia) and now she is on the formal call roster having safely and effectively completed >10 assessments.
Conclusion: To our knowledge this is the first international registration to provide telestroke across international boundaries involving a clinician with no prior work experience in the foreign country. Proving feasibility and sustainability opens the door for future service models to especially support low and middle income countries or to take advantage of international time zone differences to ease out of hour call burden.