Web-based data and knowledge sharing between stroke units and general practitioners

We describe a telemedicine application for emergency management in Stroke Units, where prompt decisions must be taken, often knowing neither the clinical history nor the stroke symptoms onset modality. We have designed and implemented an Information and Communication Technology architecture for the situation in which a general practitioner is called for a suspected stroke and provides for the admission to a Stroke Unit. By means of a palmtop and a wireless Internet connection, he can send to the Stroke Unit the demographic data, the list of the patient's problems, current and/or recent therapies, and a guideline-based stroke-specific form with the objective examination results. In this way, the Stroke Unit team is alerted and informed before the patient arrival, and can manage the urgency at the best. The proposal involved 20 general practitioners and one Stroke Unit in the Lombardia Region, Italy.