NDLI: Telemedicine remote controlled stroke evaluation and treatment, the experience of radiographers, paramedics and junior doctors in a novel rural stroke management team

Content Provider	Springer Nature : BioMed Central
Author	Kjelle, Elin Myklebust, Aud Mette
Abstract	Background In the case of ischemic stroke, access to a Computed Tomography (CT) scanner and the start of thrombolytic therapy immediately is imperative. Transport to the nearest hospital from the remote, rural area of Hallingdal in Norway entails a 2–3 h drive. The local medical centre in this area has a CT-scanner operated by radiographers during office hours. Out-of-hours stroke evaluation and treatment has been the focus of a research project. Paramedics position the patient in the CT-scanner. A radiographer at the participating hospital runs a remote-controlled scan and a junior doctor instructs a paramedic in the performance of a neurological examination. The aim of this study was to explore how radiographers, paramedics and junior doctors experience conducting telemedicine-based stroke evaluation and treatment. Methods Six semi-structured interviews were conducted with radiographers, paramedics and junior doctors; with remote control, CT examination and stroke management as central issues. Core issues in the interview guide were: communication; cooperation; competence; service quality and training. The study employed thematic content analysis in analysing the data inductively. Results The analysis gave an overview of the patient flow and communication routines in this service. Further findings were divided into two main themes, “Teamwork” and “Quality”. The theme “Teamwork” included three categories “Communication”, “Trust and confidence”, and “Task and task shifting”. The theme “Quality” included two categories “Education and training” and “Safety and routines”. The respondents considered the service to be of high quality and that the team functioned at a high level as a result of regular training sessions. However, communication and image reading routines could be improved. Conclusions The telemedicine-based, remote controlled, stroke evaluation and treatment was experienced, by the participants, to be well organised and of high quality. Communication and image reading appear to be the salient challenges. Regular training sessions and follow-up, as well as an evaluation of incidents by the project manager, proved to be of great importance in retaining and securing the continued running of the service and ensuring high-quality treatment. Further research is indicated in the comparison of this telemedicine service with stroke treatment given in a mainstream hospital.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-021-06591-1.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-021-06591-1
Journal	BMC Health Services Research
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-06-05
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Rural CT Telemedicine Stroke management
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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