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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01118

A Visual Task Management Application for Acute Ischemic Stroke Care

 Shoji Matsumoto1*, Hiroshi Koyama2,  Ichiro Nakahara1, Akira Ishii3, Taketo Hatano4, Tsuyoshi Ohta5,  Koji Tanaka6, Mitsushige Ando7, Hideo Chihara4, Wataru Takita8,  Keisuke Tokunga9,  Takuro Hashikawa10, Yusuke Funakoshi11,  Takahiko Kamata4, Eiji Higashi12,  Sadayoshi Watanabe1, Daisuke Kondo4, Atsushi Tsujimoto13, Konosuke Furuta14, Takuma Ishihara15, Tetsuya Hashimoto16, Junpei Koge17, Kazutaka Sonoda18, Takako Torii19, Hideaki Nakagaki20, Ryo Yamasaki6, Izumi Nagata4 and  Jun-ichi Kira6
  • 1Faculty of Medicine, Fujita Health University, Japan
  • 2Advanced Institute of Industrial Technology, Japan
  • 3Department of Neurosurgery, Kyoto University Hospital, Japan
  • 4Department of Neurosurgery, Kokura Memorial Hospital, Japan
  • 5Department of Neurosurgery, Medical School, Kochi University, Japan
  • 6Department of Neurology, Neurological institute, School of Medical Sciences, Kyushu University, Japan
  • 7Department of Neurosurgery, Shiga General Hospital, Japan
  • 8Department of Neurology, Nagoya Medical Center (NHO), Japan
  • 9National Hospital Organization Kyushu Cancer Center, Japan
  • 10St. Mary's Hospital (Tokyo), Japan
  • 11Department of Neurosurgery, Kobe City Medical Center General Hospital, Japan
  • 12Department of Cerebrovascular Medicine, Saga-Ken Medical Centre Koseikan, Japan
  • 13Department of Neurology, Japan Community Health Care Organization, Japan
  • 14Department of Neurology, Kokura Memorial Hospital, Japan
  • 15Innovative and Clinical Research Promotion Center, Gifu University Hospital, Japan
  • 16Department of Neurology, University of California, San Francisco, United States
  • 17National Cerebral and Cardiovascular Center (Japan), Japan
  • 18Department of Neurology, Saiseikai Fukuoka General Hospital, Japan
  • 19Graduate School of Medical Sciences, Nagoya City University, Japan
  • 20Department of Neurology, Fukuoka City Hospital, Japan

Background: To maximize the effect of intravenous (IV) thrombolysis and/or endovascular therapy (EVT) for acute ischemic stroke (AIS), stroke centers need to establish a parallel workflow on the basis of a code stroke (CS) protocol. At Kokura Memorial Hospital (KMH), we implemented a CS system in January 2014; however, the process of information sharing within the team has occasionally been a burdensome.
Objective: To solve this problem using information communication technology (ICT), we developed a novel application for smart devices, named “Task Calc. Stroke” (TCS), and aimed to investigate the impact of TCS on AIS care.
Methods: TCS can visualize the real-time progress of crucial tasks for AIS on a dashboard by changing color indicators. From August 2015 to March 2017, we installed TCS at KMH and recommended its use during normal business hours (NBH). We compared the door-to-computed tomography time, the door-to-complete blood count (door-to-CBC) time, the door-to-needle for IV thrombolysis time, and the door-to-puncture for EVT time among three treatment groups, one using TCS (“TCS-based CS”), one not using TCS (“Phone-based CS”), and one not based on CS (“non-CS”). A questionnaire survey regarding communication problems was conducted among the CS teams at 3 months after the implementation of TCS.
Results: During the study period, 74 patients with AIS were transported to KMH within 4.5 hours from onset during NBH, and 53 were treated using a CS approach (phone-based CS: 26, TSC-based CS: 27). The door-to-CBC time was significantly reduced in the TCS-based CS group compared to the Phone-based CS group, from 31 to 19 minutes (p = 0.043) Other processing times were also reduced, albeit not significantly. The rate of IV thrombosis was higher in the TCS-based CS group (78% vs. 46%, p = 0.037). The questionnaire was correctly filled in by 34/38 (89%) respondents, and 82% of the respondents felt a reduction in communication burden by using the TCS application.
Conclusions: TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.

Keywords: Acute ischemic stroke, Endovascular Therapy, intravenous thrombolysis, Processing times, visual task management

Received: 20 May 2019; Accepted: 07 Oct 2019.

Copyright: © 2019 Matsumoto, Koyama, Nakahara, Ishii, Hatano, Ohta, Tanaka, Ando, Chihara, Takita, Tokunga, Hashikawa, Funakoshi, Kamata, Higashi, Watanabe, Kondo, Tsujimoto, Furuta, Ishihara, Hashimoto, Koge, Sonoda, Torii, Nakagaki, Yamasaki, Nagata and Kira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Shoji Matsumoto, Faculty of Medicine, Fujita Health University, Aichi, 470-1192, Japan, shoji.neuro@gmail.com