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Using routine data for quality assessment in NeuroNet telestroke care
Stephan Theiss1, Franziska Günzel, Anna Storm
1Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Faculty of Economics and Management, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Routine clinical data analysis showed the telemedical NeuroNet concept improved acute stroke care. The NeuroNet network increased thrombolytic therapy rates and improved stroke care coding, demonstrating its effectiveness in telestroke network optimization.
Area of Science:
- Neurology
- Telemedicine
- Health Services Research
Background:
- Systematic clinical trials for telestroke networks are limited.
- Routine clinical data offers a complementary approach for evaluating telestroke network effectiveness.
- This study analyzed 4 years of routine clinical data to assess a telestroke network's impact.
Purpose of the Study:
- To evaluate the impact of the telemedical NeuroNet concept on acute stroke care.
- To assess improvements in thrombolytic therapy rates and in-hospital mortality.
- To examine changes in comprehensive stroke care coding following network implementation.
Main Methods:
- Comparison of routine clinical data from the HELIOS hospital information system before and after NeuroNet implementation.
- Analysis of three hospital cohorts: comprehensive stroke centers, NeuroNet hospitals, and matched control hospitals.
- Inclusion of neurologic acute stroke teleconsultations, standard operating procedures, and peer review quality management in the NeuroNet concept.
Main Results:
- Thrombolytic therapy rates increased by 4.8% in NeuroNet hospitals.
- Ischemic stroke in-hospital mortality showed a relative risk reduction of approximately 29% in both NeuroNet and control hospitals.
- Comprehensive stroke care coding increased by 45% in NeuroNet hospitals (P < .0001) and 18% in control hospitals.
Conclusions:
- Routine clinical data effectively reflect improvements in acute stroke care metrics.
- The telemedical NeuroNet concept, coupled with unified quality management, enhances stroke care.
- Similar data evaluation processes can be utilized for quality monitoring in other telestroke networks.
