Stroke Angel: Evaluation and improvement of the preclinical and clinical interface with telemedical support

In case of stroke there is no time to lose. Patients with symptoms of stroke need to be transported to the next qualified hospital - a stroke unit - as fast as possible. First aiders, paramedics, emergency physicians and clinic doctors have to work closely together to manage these emergency processes. Stroke Angel, a telemedicine approach, has shown how a mobile information system can optimize processes in the chain of survival and improve stroke care. The Stroke Angel system consists of a Handheld-PC connected to a patient card reader that communicates with a mobile phone via Bluetooth. Paramedics use Stroke Angel along with conventional medical devices, such as electrocardiographs. The card reader records the patient's personal and insurance data. The Stroke Angel device supports stroke diagnosis with the help of a structured checklist: the paramedic checks and enters various indicators of neurological problems, such as delayed speech or movement, guided by the system. Then, the paramedic can send this checklist and the emergency protocol to the hospital via GPRS/ UMTS. Secure Sockets Layer (SSL) encryption secures data transmission via both client and server authentication. When the new patient data arrives at the hospital, the Stroke Angel server triggers an alert, which lets clinicians prepare for stroke treatment while the patient is still on route. The system automatically files a new electronic patient record in the hospital information system on the basis of the incoming Stroke Angel patient data and after confirmation by reception. Although the preclinical time has not taken a significant change, the intersectional information transfer induces a reduction of around 50 % within clinical time. Meanwhile, the Cardio Angel has been developed. Similar to Stroke Angel, the EMS uses Cardio Angel to enter patients' data in case of a heart attack and sends this data to the next correct hospital (with cardiac catheter laboratory)