Neurointervention.  2017 Sep;12(2):69-76. 10.5469/neuroint.2017.12.2.69.

Mobile Real-time Tracking of Acute Stroke Patients and Instant, Secure Inter-team Communication - the Join App

• Munich SA
• Tan LA
• Nogueira D
• Keigher KM
• Chen M
• Crowley RW
• Conners JJ
• Lopes DK

• KMID: 2389498
• DOI: http://doi.org/10.5469/neuroint.2017.12.2.69

Abstract

PURPOSE
The primary correlate to survival and preservation of neurologic function in patients suffering from an acute ischemic stroke is time from symptom onset to initiation of therapy and reperfusion. Communication and coordination among members of the stroke team are essential to maximizing efficiency and subsequently early reperfusion. In this work, we aim to describe our preliminary experience using the Join mobile application as a means to improve interdisciplinary team communication and efficiency.
MATERIALS AND METHODS
We describe our pilot experience with the initiation of the Join mobile application between July 2015 and July 2016. With this application, a mobile beacon is transported with the patient on the ambulance. Transportation milestone timestamps and geographic coordinates are transmitted to the treating facility and instantly communicated to all treatment team members. The transport team / patient can be tracked en route to the treating facility.
RESULTS
During our pilot study, 62 patients were triaged and managed using the Join application. Automated time-stamping of critical events, geographic tracking of patient transport and summary documents were obtained for all patients. Treatment team members had an overall favorable impression of the Join application and recommended its continued use.
CONCLUSION
The Join application is one of several components of a multi-institutional, interdisciplinary effort to improve the treatment of patients with acute ischemic stroke. The ability of the treatment team to track patient transport and communicate with the transporting team may improve reperfusion time and, therefore, improve neurologic outcomes.

Keyword

Mobile smartphone application; Acute ischemic stroke management; Acute ischemic stroke workflow

MeSH Terms

Ambulances
Humans
Mobile Applications
Pilot Projects
Reperfusion
Stroke*
Transportation

Figure

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  Fig. 1 Stroke 60 Workflow Algorithm. The Join application has been integrated into our Stroke 60 workflow.

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  Fig. 2 Initial notification that is sent to the entire treatment team. This notification contains basic demographic and contact information, as well as time of onset (or last known well).

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  Fig. 3 Chat thread demonstrating time-stamped critical events during patient management and triage. These time stamps can be viewed by the entire treatment team. Members of the treatment team can also notify other members of the patient progress, in this case that the imaging was favorable for endovascular intervention.

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  Fig. 4 Real-time patient tracking feature of the Join application. The patient's pick-up time and location can be seen (A). Transport to the hospital can also be tracked in real-time (B).

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  Fig. 5 Results of survey administered to physicians, nurse practitioners, nurses, radiation technologists, and EMS personnel using the Join application. Questions are listed below:1. I like the concept of the Join application2. I have obtained information about transfers via Join earlier than the traditional method of pages/calls.3. I find that I have less downtime waiting for the patient due to the ability to track patient location.4. Information has been reliable.5. I feel the data collected in Join should be made a permanent part of the patient medical record.6. It is an easy-to-use application.7. It adds extra work to an existing process.8. Information technology support is always accessible for problems that arise.9. I recommend continuing this method of team communication.

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