Exploratory Evaluation of Dual Digital Platforms for Acute Brain Conditions in Medically Underserved Rural Areas : A...

To describe an exploratory initial experience with two complementary digital platforms consisting of an AI-based telemedicine system and an SNS-based transfer coordination network, for acute brain conditions in rural areas with limited or no on-site neurosurgical coverage.

We retrospectively reviewed patients with acute brain conditions who first presented to rural hospitals and were subsequently transferred to a regional hub hospital between January 2024 and March 2025. Transfers were coordinated using either an AI-integrated CT telemedicine platform or an SNS-based (KakaoTalk) collaboration network. Outcomes were assessed using the 3-month modified Rankin Scale (mRS), with favorable outcome defined as 0-2.

Eight patients (mean age 70.5 years) were managed via the AI platform, which supported collaboration between non-expert rural clinicians and hub-hospital neurospecialists. Referrals were initiated by general practitioners (n=5), an internist (n=1), and nurses (n=2). AI-assisted CT screening with integrated teleconsultation facilitated timely diagnostic clarification and early management. All eight patients had favorable outcomes at 3 months. Twelve patients were managed via the SNS platform for inter-hospital transfer. 11 required neurocritical care and 3 underwent neurosurgical or endovascular intervention after transfer. Overall, 9 patients achieved favorable functional outcomes (3-month mRS score, 0-2).

This exploratory study describes the potential utility of a dual-platform strategy integrating AI-based telemedicine and SNS-based transfer coordination for supporting acute brain condition management in medically underserved rural areas. Further prospective studies are needed to determine whether this approach improves time-sensitive transfer processes and clinical outcomes.