# Workflow optimization in acute stroke therapy using a mobile application – a pilot study

## TL;DR

A mobile app was tested to improve stroke care communication and documentation, but it did not speed up treatment times despite boosting documentation rates.

## Contribution

This pilot study evaluates a mobile app's impact on acute stroke care workflows and highlights the importance of training for effective adoption.

## Key findings

- Documentation rates tripled for all patients and increased 1.5-fold for those receiving recanalization therapy.
- The app's most used features were documentation (76%) and case information retrieval (52%), with other features underutilized.
- Treatment times like DNT and DGT did not improve after app implementation.

## Abstract

Timely treatment of ischaemic stroke with intravenous thrombolysis (IVT) and endovascular treatment (EVT) depends on efficient communication within a multiprofessional team. Mobile applications can streamline communication and documentation processes in acute stroke care.

This study aims to implement a mobile app to facilitate digital documentation and communication in acute stroke care and evaluate its impact on documentation rates and treatment times. Furthermore, a user experience survey was performed to gather information about the app usage in an acute medical process.

The study is designed as an observational post-market clinical follow-up cohort study.

The mobile app ‘Join’ was implemented in a tertiary stroke care centre. Feasibility was assessed by monitoring documentation rates and process times, that is, ‘door-to-needle time’ (DNT) and ‘door-to-groin time’ (DGT). All patients treated for suspected stroke or transitory ischaemic attack were included in a 6-month period prior to (T1) and a 3-month period after (T2) implementation of the Join app. User experience was evaluated through a standardized survey including technical features.

The interface between the mobile application, hospital information, picture archiving and communication, and quality assurance system as well as various magnetic resonance imaging/computer tomography scanners was implemented for acute stroke care. A total of 504 stroke patients was treated, 334 in T1 and 170 in T2. Of these, 65 received IVT and 87 received endovascular treatment (EVT). DNT (T1 vs T2, 27.5 vs 32 min, p = 0.987) and DGT (T1 vs T2, 50 vs 61.5 min, p = 0.481) were numerically longer during T2. Documentation rates increased threefold for all patients and 1.5 times for those receiving recanalization therapy. The survey revealed that documentation (76%) and case information retrieval (52%) were the most used app features, while other functionalities were less frequently utilized.

Implementing a mobile app facilitated real-time digital documentation accessible to the entire stroke care team. The introduction of the app did not improve treatment times for patients receiving acute recanalizing therapies. We recommend systematic training programmes to promote user acceptance and effective use.

Improving stroke treatment efficiency with a mobile app: a pilot study

This study tested a mobile application designed to improve communication and documentation in acute stroke care. The application was implemented at a stroke care center to evaluate its impact on documentation completeness and treatment times. Results showed a significant increase in documentation rates but no effect on treatment times. The app’s most used features were documentation and retrieving patient information, while other functionalities were less popular. The study suggests that mobile apps can streamline acute stroke care and recommends training programs to ensure effective use by medical teams.