mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

Area of Science:

• Neurology
• Emergency Medicine
• Health Informatics

Background:

• Acute stroke care coordination is critical for improving patient outcomes.
• Mobile technology offers potential for real-time data sharing in emergency medical services (EMS).
• The Stop Stroke (Pulsara, Inc.) application facilitates acute stroke care coordination.

Purpose of the Study:

• To evaluate the impact of activation method (EMS vs. emergency department [ED]) and time on clinical metrics in acute stroke care.
• To assess the effectiveness of the Stop Stroke mobile application in optimizing stroke treatment times.

Main Methods:

• Retrospective cohort analysis of 2589 stroke cases across 12 medical centers (March 2013-May 2016).
• Comparison of door-to-needle (DTN) and door-to-CT (DTC) times, and rate of DTN ≤ 60 minutes (goal DTN).
• Statistical adjustment for confounders (age, sex, NIHSS) using multiple regression models.

Main Results:

• EMS activation was associated with more severe strokes (median NIHSS 8 vs. 4) and higher rates of recombinant tissue plasminogen activator use (20% vs. 12%).
• EMS activation resulted in significantly shorter DTC (6.1 min) and DTN (12.8 min), and increased likelihood of meeting goal DTN (OR 1.83).
• Activation between 1200 and 1800 correlated with longer DTC (7.7 min) and DTN (21.1 min), and a reduced rate of goal DTN (OR 0.3) compared to 0000-0600.

Conclusions:

• Real-time prehospital data via smartphone technology offers valuable insights into acute stroke care.
• Mobile electronic stroke coordination activated in the field expedites and improves the success of acute stroke care processes.
• The findings support the integration of mobile health technology for enhanced prehospital stroke management.