[Kim Gil-won's Health Note] Ambulance and medical staff communicate through app... “Stroke treatment shortened to 90 minutes”

Stroke is a race against time. When brain blood vessels are blocked or ruptured, brain cells are quickly damaged, so survival and aftereffects depend on how quickly you arrive at the hospital and receive treatment.

However, even if the ambulance quickly transports the patient to the hospital, it will inevitably take time for emergency room medical staff to determine the patient's condition and prepare for examination and treatment. Therefore, rapid information transfer between the ambulance and hospital during the patient transfer stage is of utmost importance.

However, research results have shown that such information delivery can be solved with mobile apps. By using this app, the time from the onset of symptoms to the first injection treatment for stroke patients was reduced by about 90 minutes compared to before.

According to the international academic journal 'JMIR Medical Informatics', the joint research team of Professor Daehee Kang of Seoul National University College of Medicine's Department of Preventive Medicine, Dr. Eunah Kim of the Korea Institute for Health and Social Affairs, and Researcher Jinhyang Kim of Sears confirmed these results by analyzing the effectiveness of the emergency transport system using a mobile app on 163 stroke patients in Pohang, Gyeongsangbuk-do.

This study was conducted based on a pilot project in which two fire departments, eight 119 emergency and safety centers, and three hospitals in the Pohang area participated from December 2023 to April 2024.

The research team transferred 34 of 163 patients confirmed to have cerebral infarction and cerebral hemorrhage in an ambulance equipped with a mobile app called 'Brain Saver', and transferred the remaining 129 patients to the same hospitals using the existing method and compared the treatment time.

Brain Saver is an app developed to allow paramedics and emergency room medical staff to share patient information in real time.

When a paramedic enters the patient's symptoms and condition at the scene, the app provides stroke evaluation results and information on nearby hospitals. Once the transfer hospital is selected, a notification is sent to the medical staff, and the patient's biometric information is also shared through a wearable electrocardiogram device attached to the ambulance.

In particular, a notification is sent even 5 minutes before the ambulance arrives at the hospital, allowing medical staff to check the patient's condition in advance and prepare for necessary tests and treatment. If necessary, it is also possible for paramedics and medical staff to communicate through messages or video calls.

As a result of the study, the median time from symptom onset to first injection treatment was 114 minutes in the app-using group, which was 90 minutes shorter than the 204 minutes in the existing transfer group. The difference between the two groups was statistically significant.

When the research team re-analyzed 91 comparable patients, taking into account the patient's age, stroke severity, presence of cerebral infarction or cerebral hemorrhage, and transfer hospital, the effect of reducing treatment time was confirmed.

In this analysis, the time from symptom onset to first injection treatment in the app-using group was 51% shorter than the traditional transport group. The time from arrival to the emergency room to first injection treatment was also found to be shortened by 33%.

What is noteworthy is that there was no statistically significant difference between the two groups in the time from symptom onset to hospital arrival.

This shows that the information sharing system, which allows medical staff to identify the patient's condition and prepare for treatment before arriving at the hospital, may have contributed to reducing treatment delays.

The research team evaluated that this result shows the potential of a digital emergency medical system that connects ambulances and emergency rooms in real time. However, in order to generalize the effect and expand application nationwide, follow-up research with more patients was needed.

In fact, this study did not confirm whether app use actually lowers the risk of death or disability.

Challenges for field application were also identified. Of the 42 paramedics surveyed about their experience using the app, 36% responded that they had difficulty entering patient information. Medical staff also pointed out the need to improve issues such as workload due to frequent notifications and patient information protection.

Professor Daehee Kang (Chairman of the Asian Telemedicine Society) said, "This study is meaningful in that it shows the possibility of increasing the speed of emergency medical care simply by efficiently connecting existing medical resources using digital technology in areas where medical personnel and facilities are relatively lacking."

“So far, when talking about local medical innovation, the focus has been on expanding medical resources, such as increasing the number of doctors and building hospitals,” he said. “However, as there are limits to simply increasing medical personnel and facilities, institutional innovation that efficiently connects existing medical resources using digital health technology and telemedicine must be carried out in parallel.”