With the dawn of telemedicine, thrombolytic treatment is extended to nonurban areas with a digital network that includes a two-way video conference system and CT/MRI image transfer. Physicians in these hospitals are able to contact the stroke centers 24 hr/day. In the Telemedic Pilot Project for Integrative Stroke Care, door-to-needle time was, on average, 76 min, which included 15 min for the teleconsultation (37) . Emergency department-based TeleStroke might facilitate rtPA delivery in stroke neurology underserved facilities (38 ), and the future holds greater possibilities.

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