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PrehospIT – IT promoting better ambulance medical care

The national collaborative project PrehospIT Stroke , is led by Prehospital ICT Arena. The project aims to improve conditions for the efficient use of ICT/eHealth in prehospital healthcare by laying the foundations to harmonize semantic and technical interoperability at national level. The project manages information and communication that improves the patient care process at each stage from the emergency call to 112 to care at the right hospital.

 

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In the long-term, PrehospIT will contribute to better ICT support and solutions during the ambulance mission as well as follow up, operational development and quality assurance at both local and national level. The project is financed by Vinnova, together with the 21 participating parties from healthcare, business and academia from throughout Sweden.

Health and medical care is undergoing a digitization process that affects all areas and operations. One important component in this is that all relevant systems are able to communicate with and understand each other, i.e. support semantic and technical interoperability. To solve this may seem easy, but considerable resources are being invested at regional, national and international levels in this challenge, where a solution still remains to be found and practicable applications can only be used to a limited extent. The PrehospIT project addresses this problem within the prehospital arena with stroke as the first application area, and with the ambition to deliver a tested open recommendation concerning semantic and technical interoperability. On the basis of the recommendation, the project group wants to define and illustrate a future direction moving forward within prehospital ICT where interoperability can be managed in a pragmatic manner.

“Many parties and systems collaborate within the prehospital healthcare chain. At the present time, there is no common view for how information, concepts and documentation should be managed to offer the greatest benefits to healthcare and patients. In addition, there is no common view for the technical link between the various systems in use. Finding a common language and overcoming the technical barriers would pave the way for a faster, better and safer assessment and treatment at the acute phase. And also significantly improve opportunities for follow-up and operational development,” says Bengt Arne Sjöqvist, program coordinator at Lindholmen Science Park and Professor of Practice in Healthcare Informatics at Chalmers University of Technology.

More specifically, the project will draft proposals for how ICT should be jointly coordinated and developed between all of the actors involved in the care chain in order to improve ambulance medical care. This work includes finding common concepts and improving technical cooperation between existing systems. The proposal will be tested in practice in the care chain for acute stroke, and aims to demonstrate faster and more effective help to patients.

The choice of the acute stroke chain as the first application is only natural. Every year, approximately 25,000 people in Sweden suffer a stroke. It is the most expensive somatic disease in Sweden, as it leads to more days spent in care at hospitals and hospices than any other physical illness. The annual cost has been estimated in the region of SEK 19 billion. 

The illness affects primarily older people, over 70, but also many younger people. Studies have shown that approximately 20% die, while 30% become functionally dependent, which means that they require assistance from another person for basic things such as going to the toilet, or they need to live in residential care. In terms of size, 50% are deemed “functionally independent” but this group can have various levels of neurological disorders – sometimes for life. 

In the case of an acute stroke, the time to correct treatment is highly important and is critical for the outcome. Different treatment alternatives are relevant depending on the type and size of stroke, and distance to the hospital for treatment. These include thrombolysis, thrombectomy or neurosurgery, where the latter two are only provided at university hospitals.

The introduction of thrombectomy into acute stroke care will increase quality demands on prehospital assessment. Ambulances can no longer drive straight to the nearest thrombolysis hospital, but must instead assess whether the patient should be taken directly to a hospital for thrombectomy or pass by a thrombolysis hospital on the way. To make these types of critical decisions with a high degree of certainty, ICT solutions as those demonstrated in PrehospIT are extremely important.

In addition to IT support, video solutions for prehospital consultation will be studied and recommended.

The PrehospIT project will be conducted in a number of phases:
I.    International standards inventory, analysis and recommendation for interoperability
II.   Technical tests of the recommendation in a lab environment (“Connectathon”)
III.  Clinical evaluation utilizing  full-scale simulations of the stroke medical care chain based on realistic “use cases”.
IV.  Analyses of simulation results and dissemination of results

PrehospIT is now in phase IV and will be concluded in spring 2017.

PrehospIT-Stroke was designed within the Metis Forum.

If you want to be involved in the work, please contact:

Bengt Arne Sjöqvist, Programme manager, Lindholmen Science Park.
Email: bengt.arne.sjoqvist@lindholmen.se