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Electronic Stroke CarePath: Integrated Approach to Stroke Care.

Irene L Katzan1, Youran Fan2, Micheal Speck2

  • 1From the Center for Outcomes Research and Evaluation, Neurological Institute (I.L.K., Y.F., S.D.G., M.M.), Information Technology Division, Clinical Systems Office (I.L.K., L.F., J.U.), Cerebrovascular Center, Neurological Institute (I.L.K., K.U., M.M.), and Lerner Research Institute, Quantitative Health Sciences (Y.F., S.D.G.), Cleveland Clinic, OH; and Speck Technologies, Cleveland, OH (M.S.). katzani@ccf.org.

Circulation. Cardiovascular Quality and Outcomes
|October 31, 2015
PubMed
Summary

The Electronic Stroke CarePath improves ischemic stroke management by integrating care pathways into electronic health records. This initiative showed a decrease in inpatient mortality and a trend toward better functional outcomes for stroke patients.

Keywords:
clinical pathwaysmedical informaticsquality of health carestroke

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Area of Science:

  • Neurology
  • Health Informatics
  • Clinical Quality Improvement

Background:

  • Ischemic stroke requires efficient and high-quality care management.
  • Electronic health records offer potential for streamlining stroke care pathways.
  • Integrating patient-reported outcomes is crucial for comprehensive stroke management.

Purpose of the Study:

  • To describe the development and implementation of the Electronic Stroke CarePath.
  • To evaluate the impact of the CarePath on efficiency and quality of ischemic stroke care.
  • To assess changes in inpatient mortality and functional outcomes post-implementation.

Main Methods:

  • Developed and integrated ischemic stroke care pathways within the electronic health record.
  • Utilized an external platform for collecting patient-reported outcomes.
  • Compared inpatient mortality and length of stay before and after CarePath implementation.
  • Analyzed postdischarge functional outcomes between early and later periods of the study.

Main Results:

  • 1106 ischemic stroke patients were managed via the CarePath from January 2011 to December 2012.
  • A significant decline in inpatient mortality was observed for ischemic stroke patients post-implementation.
  • No significant change in mortality was noted for control groups with other types of stroke.
  • A 72.9% completion rate for patient-reported outcome questionnaires was achieved.
  • A trend towards improved functional outcomes was observed with CarePath use.

Conclusions:

  • The Electronic Stroke CarePath is feasible to implement in clinical practice.
  • The initiative shows potential benefits for multiple ischemic stroke outcomes.
  • This electronic approach represents a promising strategy for future stroke care optimization.