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“The sky is the limit” – how digital health technologies can help improve stroke care

The field of stroke care has changed greatly in the past year, with the COVID-19 pandemic prompting an accelerated use of digital health technologies, including software applications, virtual care, and wearable devices.1

Here I will discuss recent experiences with new digital technologies, and some practical lessons learned. It should be noted that technologies can contribute not only to the management of acute stroke, including screening by emergency services, but also to stroke prevention (both primary and secondary), education, rehabilitation, and quality control.

Using apps in the acute phase: before admission

Accurate pre-hospital assessment is essential in order to inform decisions about care, such as whether or not the patient needs to be transported to a center capable of performing endovascular treatment. In our region of Brazil, we have been using the Field Assessment Stroke Triage for Emergency Destination (FAST-ED) app, which helps the user identify stroke due to large vessel occlusion.

This triage app uses an algorithm based on patient factors such as age, time last known normal, motor weakness, deviated gaze, and aphasia. It also provides access to information about the capabilities of local and regional stroke centers, in terms of their ability to provide endovascular treatment, combined with global positioning system (GPS) data and real-time traffic information. This allows users to establish eligibility for treatment (e.g. intravenous tissue plasminogen activator or endovascular) and identify where the patient should be sent for the most effective care.