On the road to smarter stroke care

  • Andrew Bivard & Mark Parsons in an Australian-first advanced telehealth platform coming to rural and remote ambulance services (photo by Josh Robenstone).

Andrew Bivard & Mark Parsons in an Australian-first advanced telehealth platform coming to rural and remote ambulance services (photo by Josh Robenstone).

The Australian Stroke Alliance is set to introduce a truly national telehealth network to speed up pre-hospital stroke diagnosis and treatment.

Stroke-ready road ambulances will be trialled early next year in both the Hunter and south-west Sydney regions of New South Wales and rural Victoria. They will be loaded with a tailored telehealth platform that will provide an unprecedented level of support for first responders.

Within 18 months, the Australian Stroke Alliance also hopes to be transporting lightweight brain scanners within road and air ambulances, in partnership with the nation’s ambulance authorities and the Royal Flying Doctor Service.

The telehealth platform, known as Zeus, really is the backbone of the program. It has been designed by perfusion imaging specialist Associate Professor Andrew Bivard and neurologist Professor Mark Parsons, in collaboration with partners around the country. The Zeus app is already being tested in the field and is performing exactly as anticipated on Melbourne’s mobile stroke ambulance.

The Zeus app allows essential clinical data to be shared with the receiving hospital, influencing treatment decisions and increasing the safe and timely delivery of medications. Sometimes, that will mean the stroke ambulance needs to go past the nearest hospital to reach a specialist stroke centre where an endovascular team is prepped, ready to remove a clot from a blocked blood vessel.

According to Professor Parsons, ‘Getting the right patient to the right hospital as quickly as possible is critical. The stroke-capable ambulance program will truly connect our pre-hospital paramedic clinicians with stroke specialists and enable more accurate diagnosis in the field.

‘The communication system developed by Andrew, with the support of the Australian Stroke Alliance, will allow “scrambling” of the in-hospital emergency department, stroke and radiology teams to fast-track brain imaging and brain-saving treatment.

‘Based on the Melbourne mobile stroke ambulance model, we know this may lead to earlier treatment by up to two hours. The impact of treating even one hour earlier provides a stroke survivor with more than one extra year of disability-free life.’

Associate Professor Bivard adds, ‘Shortening the communication chain with telehealth may allow medical teams to get the right patient to the right place much sooner. This is important because we know that earlier treatment improves individual patient outcomes’.

Customised features are accessed from a phone or web browser with audiovisual assessment of a patient, phone camera and image sharing, region-specific patient assessment forms, pre-notification for clinicians, individual patient record export, administrator automatic reporting and data collection for analysis. Within two years, it is hoped imaging will be undertaken in the vehicle and transmitted via Zeus.

The Australian Stroke Alliance’s Chief Executive Officer Dr Damien Easton says, ‘This is a unique opportunity as we’re a fully funded research program and can offer a co-designed, region-specific telehealth solution with Zeus and other technologies.

‘We’re speeding up diagnosis by linking first responders to support in a profound way. Zeus is not a commercial, off-the-shelf product and is free of large-scale tender processes and the complications of myriad stakeholders.

‘Our approach invites co-design with partners and the Zeus platform will ensure ambitious initiatives like stroke-ready ambulances will hit the road next year, and [is] why we expect air mobile stroke units to take off in 2023.’

This project is an initiative of the Australian Stroke Alliance, bringing together 37 organisations committed to improving urgent pre-hospital stroke care across the nation. To find out more, visit www.austrokealliance.org.au

The Australian Stroke Alliance is an initiative of the Australian Government.

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