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by Dr Leonard Fuhry
Published on 17 February 2016

Dr Leonard Fuhry, Senior Physician in the Neurological Department at Klinikum Ingolstadt, discusses how his organisation is improving stroke patient outcomes by integrating and connecting vital patient data across 15 hospitals in rural Bavaria.

Acute stroke treatment has dramatically changed during the last decade. Specific therapy is now available within the first few hours after stroke onset.

Systemic thrombolysis is easy to handle, but indication should be made by an experienced neurologist. And there is little question that it’s important to rapidly identify severely affected patients that would benefit from mechanical thrombectomy.

In order to combat the challenge of providing these treatments not only to the population of metropolitan areas with specialised neurological stroke units, but also to patients in rural districts, stroke networks have been established.

The need for fast, standardised and secure communication

Klinikum Ingolstadt is one of three central hospitals in the Nevas stroke network advising 15 community hospitals in rural Bavarian districts during acute stroke treatment. As “time is brain” in acute stroke treatment, communication has to be fast, standardised and secure.

Brain imaging (e.g. CT) is typically performed early in the diagnostic course of a stroke, which means that both patient data and images have to be provided to the advising hospitals. So, we decided to utilise administrative data contained in the DICOM header, which is always sent together with the images.

Developing an electronic case record for the stroke network

Based on a Cerner Soarian® Integrated Care solution recently established at Klinikum Ingolstadt, we developed an electronic case record for the complete stroke network. The case record includes CT images provided by the community hospitals and a structured pdf form for documentation.

To minimise administrative effort during the emergency situation, the case record and prefilled forms are automatically generated as soon as DICOM images are transferred to the Klinikum Ingolstadt server. Notifications are added to the worklists of the requesting community hospital and the three consulting hospitals.

In this way, consultation requests and documentation of recommendations are completed within a few minutes, which reduces the time taken to provide specific stroke treatment at the optimum time and subsequently improves patient outcomes.

This blog was written by Dr Leonard Fuhry, Senior Physician, Neurological Department, Klinikum Ingolstadt.