Prehospital telemedicine support for urban stroke care - Analysis of current state of care and conceptualization

Oct 5, 2026

The study analyzes acute ischemic stroke care processes from symptom onset to treatment in a German city served by three stroke units, focusing on delays within the emergency care chain. An in-depth review covers prehospital and in-hospital processing times across three local stroke centers in Düsseldorf for suspected stroke transportations. Isochrone mapping identifies areas with prolonged transportation times and reveals time disparities across the city. The results support pre- and in-hospital accelerators and propose in-ambulance video consulting to contact stroke experts faster.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

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Abstract

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Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization Daniel Weiss, Christian Rubbert, Marius Kaschner, Gregory Gordon Greiner, Nadja Kairies-Schwarz, Markus Vomhof, Andrea Icks, Linea Weitz, Hanna Hollenberg, Robin Jansen, Til Menge, Rüdiger J. Seitz, Sebastian Jander, Michael Bernhard, John-Ih Lee, Tobias Ruck, Sven Guenther Meuth, Bernd Turowski, Julian Caspers & Michael Gliem Article-Version of Record Suggested Citation: Weiß, D. A. , Rubbert, C. , Kaschner, M. , Greiner, G. G. , Kairies-Schwarz, N. , Vomhof, M. , Icks, A. , Weitz, L. , Hollenberg, H. , Jansen, R. , Menge, T. , Seitz, R. , Jander, S. , Bernhard, M. , Lee, J.-I. , Ruck, T. , Meuth, S. , Turowski, B. , Caspers, J. , & Gliem, M. (2024) . Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization. BMC Emergency Medicine, 24, Article 224 . [https://doi.org/10.1186/s12873-024-01142-3](https://doi.org/10.1186/s12873-024-01142-3) Wissen, wo das Wissen ist. This version is available at: URN: [https://nbn-resolving.org/urn:nbn:de:hbz:061-20250129-101936-8](https://nbn-resolving.org/urn:nbn:de:hbz:061-20250129-101936-8) Terms of Use: This work is licensed under the Creative Commons Attribution 4 .0 International License. For more information see: [https://creativecommons.org/l](https://creativecommons.org/l)icenses/by/4 .0 Weiss et al. BMC Emergency Medicine (2024) 24:224 [https://doi.org/10.1186/s12873-024-01142-3](https://doi.org/10.1186/s12873-024-01142-3) BMC Emergency Medicine RESEARCH Open Access Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization Daniel Weiss1, Christian Rubbert1, Marius Kaschner1, Gregory Gordon Greiner2,6, Nadja Kairies‑Schwarz2, Markus Vomhof2,6, Andrea Icks2,6, Linea Weitz1, Hanna Hollenberg3, Robin Jansen3, Til Menge4, Rüdiger J. Seitz4, Sebastian Jander5, Michael Bernhard7, John‑Ih Lee3, Tobias Ruck3, Sven Guenther Meuth3, Bernd Turowski1, Julian Caspers1 and Michael Gliem3* Abstract Background The reduction of processing times in the treatment of acute ischemic stroke is of outstanding impor‑ tance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for detected treatment delays. Methods We conducted an in‑depth analysis of acute stroke care processing times across three local stroke centers in Düsseldorf among all emergency services transportations for suspected stroke. Isochrone mapping was performed to identify areas with prolonged transportation times. Results Among the 1,714 transportations, 943 patients had confirmed strokes. Prehospital care constituted 58% of total emergency care time until imaging. Patients with confirmed stroke had reduced in‑hospital times while patients receiving treatment experienced faster in‑hospital times. Isochrone mapping revealed disparities in transportation times within the city. Conclusions In conclusion, we identified confirmation of stroke symptoms as pre‑ and in‑hospital and treatment eligibility as in‑hospital process accelerators in stroke care. We propose the introduction of an in‑ambulance video consulting model to accelerate contact to stroke‑experts and accelerate processing times for patients eligible for treatment. Furthermore, we discuss the combination of in‑ambulance video consulting with imaging and starting treatment outside traditional stroke centers, followed by transportation to a stroke center during thrombolysis, which might further accelerate treatment in specific cases. Keywords Stroke, Models of care, Outcome, Cost efficiency *Correspondence: Michael Gliem Michael. Gliem@med. uni‑[duesseldorf.de](duesseldorf.de) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licens

FAQs

What is the main objective of the study?

To analyze the acute stroke care chain from onset to treatment in a city in Germany with three stroke units and to discuss solutions for detected treatment delays.

How was transportation delay variation assessed?

Isochrone mapping was used to identify areas with prolonged transportation times within the city.

What intervention does the study propose to accelerate stroke care?

Introducing an in-ambulance video consulting model to speed up contact with stroke experts and reduce processing times, potentially combined with imaging and earlier treatment outside traditional stroke centers.

Oct 5, 2026

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