The Stroke Implementation Group, part of the Wales NHS Executive, has commissioned Visionable to implement an emergency virtual triage pilot. Working within Cardiff and Vale University Health Board and alongside the Welsh Ambulance Services NHS Trust, this initiative allows stroke patients arriving by ambulance to bypass the emergency department and proceed directly to CT scanning.
Diagnosing stroke can be challenging and many patients present with stroke like symptoms known as stroke mimics. In September 2021*, across hospitals in England and Wales, 52.8% of stroke assessments were finally diagnosed as stroke mimics (6,351 mimics reported in comparison to 5,672 strokes). In Wales, the average rate of stroke patients receiving thrombolysis over the last 12 months** was 14.1% and as low as 1.4% for rate of thrombectomy. The virtual triage project is focused on supporting WAST clinicians with pre-hospital advice and triage for suspected stroke patients. Ambulance teams will be able to work more closely with hospital-based stroke teams to categorise potential stroke patients and ensure they reach the correct treatment pathway as quickly as possible, thereby reducing the number of stroke mimic attendances at A&E and increasing the thrombolysis rate for stroke patients. Additional benefits include:
- Improving patient outcomes
- Improved patient satisfaction
- Reduce mortality associated with stroke
Shakeel Ahmad, National Clinical Lead for Stroke at Cardiff and Vale UHB said: “We are excited to get this project off the ground. Our aim is to have a structured pre-hospital assessment so patients are put on the correct pathway in order to quickly access life changing treatments such as thrombolysis and thrombectomy. We hope the project will demonstrate a reduction in stroke mimics coming into hospital which will reduce the burden on the emergency department. Our vision is to digitally connect the entire stroke pathway and this is the first step in our journey.”
Visionable’s pre-hospital stroke triage solution will give WAST clinicians virtual access to an on-call team using a simple app installed on their iPads which will enable them to securely share a feed of the patient via their camera with just one-click. Hosted on Visionable’s brand new VisionableONE platform, the “see what I see” triage approach will allow the hospital-based stroke specialist to interact with the WAST Clinician and patient in real-time, with functionality to enable a 360° single view of patient diagnostics, video feeds and vital stats via a safe and secure connection.
VisionableONE brings a new era for care delivery with its simplicity and ease of use, allowing healthcare professionals to focus on what matters the most – delivering the best possible patient care for the best possible patient outcomes.
Alan Lowe, CEO of Visionable, said: “Stroke is a key priority area for Visionable. We already support the East of England to digitally deliver stroke care and are now proud to be expanding the use of our technology in Wales. We look forward to sharing the results of this project so that we can continue to drive innovation and digital transformation in other regions across the country, as well as other health conditions.”
The project aims to fully integrate the technology into the stroke care workflow for Cardiff and Vale and will provide a tried and tested blueprint for rolling out the service to other areas in Wales and other regions in the UK and beyond.
*Sentinel Stroke National Audit Programme, Mimic Audit 2021 https://www.hqip.org.uk/wp-content/uploads/2022/06/Ref.-363-SSNAP-2021-stroke-mimics-report-FINAL.pdf
**June 2022 to May 2023