The Hawaii Neuroscience Telehealth Network is a federally funded research program designed to measure how patients and professionals benefit from new telemedicine technology. When the patient develops an acute stroke from a blood clot in the brain, there is a precious three hour window in which to give a clot busting treatment called thrombolysis. Because many patients wait before coming to the emergency department, the emergency physicians have very little to time examine the patient, obtain a brain CT scan, and decide whether to treat with thrombolysis. And the decision is often tricky...Is it really a stroke?...Is the stroke big enough?...Could thrombolysis be too dangerous for this this patient?...Can thrombolysis be started early enough?