title: Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project.
abstract: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique.
  
  
  
  Successful execution of the project involved the development and validation of a novel stroke scale, design and creation of specific hardware and software solutions, execution of field tests for mobile internet connectivity, design of new care processes and information flows, recurrent training of all professional caregivers involved in acute stroke management, extensive testing on healthy volunteers, organisation of a 24/7 teleconsultation service by trained stroke experts and 24/7 technical support, and resolution of several legal issues.
  
  
  
  In all, it took 41 months of research and development to confirm the safety, technical feasibility, reliability, and user acceptance of the PreSSUB approach. Stroke-specific key information can be collected safely and reliably before and during ambulance transportation and can adequately be communicated with the inhospital team awaiting the patient.
  
  
  
  This paper portrays the key steps required and the lessons learned for successful implementation of a 24/7 expert telemedicine service supporting patients with acute stroke during ambulance transportation to the hospital.
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Alexis
authors.initials: A
authors.lastname: Valenzuela Espinoza
authors.forename: Robbert-Jan
authors.initials: RJ
authors.lastname: Van Hooff
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.forename: Maarten
authors.initials: M
authors.lastname: Moens
authors.forename: Laetitia
authors.initials: L
authors.lastname: Yperzeele
authors.forename: Koenraad
authors.initials: K
authors.lastname: Nieboer
authors.forename: Ives
authors.initials: I
authors.lastname: Hubloue
authors.forename: Jacques
authors.initials: J
authors.lastname: de Keyser
authors.forename: Andre
authors.initials: A
authors.lastname: Convents
authors.forename: Helio
authors.initials: H
authors.lastname: Fernandez Tellez
authors.forename: Alain
authors.initials: A
authors.lastname: Dupont
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
mesh_terms: D000552:Ambulances / Q000458:organization & administration* / Q000592:standards; D001530:Belgium; D019985:Benchmarking; D019091:Critical Pathways / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D003936:Diagnosis, Computer-Assisted / Q000592:standards; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D017146:Models, Organizational; D061214:Patient Safety; D010865:Pilot Projects; D015397:Program Evaluation; D019114:Remote Consultation / Q000458:organization & administration* / Q000592:standards; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000458:organization & administration* / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome