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Background: To improve rural population access to telestroke sites for referral and treatment, hospitals are required to fulfill monthly educational outreach. Telehealth sites that provide stroke outreach through awareness educational campaigns remain unaware of the efficacy of their outreach efforts. This study sought to apply a measurable scale to their outreach efforts and determine if the values correlated to the sites referral and treatment rates.Hypothesis: Measurable differences of outreach efforts in rural populations positively correlate to referral and treatment rates at telestroke hospital sites.Methods: A large telestroke network (n=48 spoke sites) had 12 consecutive months during 2016 of community outreach efforts evaluated on an educational gauge scale. Events were categorized as active or passive depending on the type of event. All events were assigned a value based on the type of event, audience size and the crowd’s level of attention/participation. Total monthly values for all spoke sites were calculated and compared by month and category. Regression analysis was used to determine significance of correlative analysis of education vs. number of referrals and vs. number of tissue plasminogen activase (tPA) treatments.Results: Outreach efforts promoting stroke awareness from all 48 sites totaled 2,625 educational points. There was a temporal trend of active events occurring in the spring (April through June) and in the fall (October). In regression analysis there was a positive correlation in the number of referrals vs. educational gauge (R=0.23; P=0.0013) and in the number of tPA treatments (R=0.20; P=0.0055). One spoke site was evaluated for their community events due to their high referral rate in the first quarter of the year. Outreach efforts during these months included stroke awareness events at local high schools, a sporting race event and to apartment residents.Conclusion: Targeted outreach efforts can now be measured for efficacy of reaching diverse populations with direct effects on referral and treatment rates.