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ThinkMind // eTELEMED 2019, The Eleventh International Conference on eHealth, Telemedicine, and Social Medicine // View article etelemed_2019_5_20_40042
Design of a Telestroke System to Optimize Healthcare Delivery for Cerebrovascular Diseases in Colombia
 Authors:
Brenda Ropero
Nicolás Useche
Antonio Salazar
Juan Pérez
Manuel Granja
Hernán Bayona
Carlos Martínez Keywords: stroke; telestroke; algorithms; software; collaborative platform. Abstract:
The purpose of this manuscript is to present the design of a software tool that supports clinical decision-making and the early transfer of patients with suspicion of cerebrovascular diseases in Colombia, We designed several clinical algorithms that comply with the latest American Heart Association and American Stroke Association (AHA/ASA) guidelines for the clinical care of a group of cerebrovascular diseases by defining multiple clinical outcomes in three different healthcare settings. Algorithms were reviewed and approved by a group of stroke experts, including a vascular neurologist, a general neurologist, and an interventional neuroradiologist. Patient data, time of symptom onset, and neurological and radiological severity scores were integrated into a comprehensive clinical workflow to increase the diagnostic sensitivity and specificity to select candidates for acute reperfusion therapies. Absolute and relative contraindications for intravenous thrombolysis and mechanical thrombectomy were incorporated to predict the need for an immediate transfer to a specialized stroke unit. These multiple variables contained in the algorithms were entered into a collaborative platform connecting three different healthcare settings with varying degrees of expertise and technological resources for stroke care. A web-based decision aid was obtained for real-time clinical decision-making. This software builds the pillars of a telestroke public-private network for the Emergency Stroke System in Colombia, guiding the clinical identification of a stroke, scoring the magnitude of the neurological deficit, and mainly suggesting whether a determined case may benefit from acute reperfusion therapies. Pages: 73 to 80 Copyright: Copyright (c) IARIA, 2019 Publication date: February 24, 2019 Published in: conference ISSN: 2308-4359 ISBN: 978-1-61208-688-0 Location: Athens, Greece Dates: from February 24, 2019 to February 28, 2019
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