A Visual Task Management Application for Acute Ischemic Stroke Care

Abstract

Background: To maximize the effect of intravenous (IV) thrombolysis and/or endovascular therapy (EVT) for acute ischemic stroke (AIS), stroke centers need to establish a parallel workflow on the basis of a code stroke (CS) protocol. At Kokura Memorial Hospital (KMH), we implemented a CS system in January 2014; however, the process of information sharing within the team has occasionally been burdensome.Objective: To solve this problem using information communication technology (ICT), we developed a novel application for smart devices, named “Task Calc. Stroke” (TCS), and aimed to investigate the impact of TCS on AIS care.Methods: TCS can visualize the real-time progress of crucial tasks for AIS on a dashboard by changing color indicators. From August 2015 to March 2017, we installed TCS at KMH and recommended its use during normal business hours (NBH). We compared the door-to-computed tomography time, the door-to-complete blood count (door-to-CBC) time, the door-to-needle for IV thrombolysis time, and the door-to-puncture for EVT time among three treatment groups, one using TCS (“TCS-based CS”), one not using TCS (“phone-based CS”), and one not based on CS (“non-CS”). A questionnaire survey regarding communication problems was conducted among the CS teams at 3 months after the implementation of TCS.Results: During the study period, 74 patients with AIS were transported to KMH within 4.5 h from onset during NBH, and 53 were treated using a CS approach (phone-based CS: 26, TSC-based CS: 27). The door-to-CBC time was significantly reduced in the TCS-based CS group compared to the phone-based CS group, from 31 to 19 min (p = 0.043). Other processing times were also reduced, albeit not significantly. The rate of IV thrombosis was higher in the TCS-based CS group (78% vs. 46%, p = 0.037). The questionnaire was correctly filled in by 34/38 (89%) respondents, and 82% of the respondents felt a reduction in communication burden by using the TCS application.Conclusions: TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.

Communication-type smartphone application can contribute to reducing elapsed time to reperfusion therapy

“…The favorable outcome rate was very high in both of the present groups compared with those reported previously [9,22]. Previous studies have reported that in-hospital medical apps [15,20], telestroke evaluation [23], and treatment by a mobile stroke unit [23,24] reduced DNT, but to the best of our knowledge, none studied the relationship between favorable outcome and improvements in the stroke care system.…”

“…Furthermore, it has been suggested that this digitization process may be accelerated in the stroke care after a global emergency represented by the COVID-19 pandemic [13]. Already, several stroke centers have trialed a medical information and communication technology (ICT) smartphone applications [14,15] with the aim of shortening IV-tPA and MT times from onset. These applications perform task management and time tracking for reperfusion therapy, and present this information visually for sharing among the stroke team.…”

Scoping review of dashboards in health care: why, how, and for whom they have been developed, implemented, and evaluated (Preprint)

“…This likely reflects that dashboards have become part of the growing burden of administrative responsibilities clinicians face [217,218]. We also found with the growth in dashboards, end users have expanded to include entire clinical teams (e.g., rapid response teams [51,111,157], care teams completing patient rounds[29,56,113]), and even patients, who often input symptoms or vital signs to supplement EHR data [104,115,147,167,171,174], reflecting the growing complexity of health care teams and trends in patient reported outcomes.…”

Therapie des akuten ischämischen Schlaganfalls

“…Verschiedene Konzepte zur Qualitätskontrolle, wie regelmäßige Nachbesprechungen der Thrombolysen bzw. App-basierte Konzepte zur Dokumentation der Prozesszeiten konnten in Studien die Wirksamkeit belegen [88][89][90].…”