Technological and service innovation in stroke care

ischaemia 2  

Technological and service innovation in stroke care

Stroke is the third leading cause of death and the single largest cause of long-term severe disability in the UK. The projects builds on our previous work on stroke care in the UK and focuses in particular on the impact changes in imaging technology could have on stroke service delivery. 

The number of patients presenting with symptoms of stroke early enough to qualify for potentially reversing thrombolytic therapy is constrained partly by the availability of imaging technology to determine that the stroke is ischemic, rather than haemorrhagic. There has been discussion about the deployment of field-based ultrasound devices and telemetry on ambulances, particularly in geographical locations that are distant from formally designated stroke treatment centres. This method represents a disruptive innovation compared to current practice because field-based imaging would make use of smaller, cheaper ultrasound devices, but which are ‘good enough’ to determine the type of stroke.

Along with colleagues from MIT and Harvard Medical School (Stan Finkelstein and Henry Feldman), we have been exploring the potential for such an approach, the organisational barriers against the required changes in stroke services, the likely benefits for patients, healthcare providers and payers in both the UK and the US. One study (with Steffen Bayer, Evin Uzun Jacobsson and Mary Joan MacLeod) has used simulation modelling to explore access to timely diagnosis of stroke in Scotland, where geography can make this challenging. We have modelled the system using discrete-event simulation, focusing on a system-wide overview of stroke care delivery after different innovative approaches. This builds on a previous project for the Department of Health using simulation modelling to explore the potential impact of innovation in stroke care - report available here.