Innovation is not the problem. The problem is that there is NO stroke leadership executing a stroke strategy to deliver 100% recovery. There are thousands of pieces of research out there that if just followed up and solved would vastly lessen the stroke burden. Execution is the problem.
Can innovation play a role in stroke care and diagnosis?
Dr. Ron Weinberger, CEO of EMVision Medical Devices, explores the roll that medtech and innovation can play in stroke care and diagnosis.
Over the past two years, global healthcare systems have been thrust into the spotlight as the world navigated the challenges of COVID-19. During this time, rapid technological advancements have played a critical role in mitigating the impacts of the pandemic.
The challenge is, medtech advancements are often considered expensive or difficult to implement, so decision makers must identify what technology is truly going to benefit operations, health outcomes and have a lasting impact.
One particularly prevalent example is the application of innovation for stroke diagnosis and care. Stroke has long been recognised as one of the world’s biggest killers and is a leading cause of serious long-term disability in the United States, costing billions of dollars per year.
With this in mind, how can innovation play a critical role in tackling this challenge head on?
Reducing time to intervention
When it comes to stroke, a person loses millions of brain cells every minute after onset and as time goes on, in the absence of treatment, the long term impact can be devastating. The best outcomes are achieved when a patient is treated within the first, or “golden”, hour after symptom onset. Before intervention can occur, urgent neuroimaging is required to distinguish between an ischaemic (a vessel blockage) and haemorrhagic (a bleed) stroke - only then can the right clinical decisions be made, and effective treatments applied. (Why do you say neuroimaging is required? Can't these much faster diagnosis options obviate the need for that slow process?
TIME IS BRAIN, you know, so I'd suggest these much much faster options.
Maybe you want these much faster objective diagnosis options.
Hats off to Helmet of Hope - stroke diagnosis in 30 seconds; February 2017
Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017
New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017
Computed tomography (CT) or magnetic resonance imaging (MRI) are the workhorses of stroke imaging today, used to detect changes in the brain and diagnose a person with stroke and most importantly, stroke type, before treatments can be administered. The ability to quickly diagnose and make timely triage and treatment decisions, particularly within the ‘golden hour’, can drastically improve the outcome for patients, long term.
Medical imaging technology like EMVision’s portable imaging device is set to accelerate this process by offering bedside decision support and monitoring of patients and, in the future, neuroimaging in ambulances. Mobile Stroke Units - heavily customised ambulances with imaging equipment and staffed by stroke experts - are highlighting the positive benefits of reducing time to diagnosis and intervention in the field and improving patient outcomes.
Investment in novel portable imaging technologies, which are suitable for environments where traditional CT or MRI services are not accessible, practical or are cost prohibitive is increasingly important to tackle time-sensitive medical emergencies like stroke.
Tackling the challenge of distance
Research suggests that nearly one quarter of Americans living in isolated regions say access to good doctors and hospitals is a major problem, compared to 18% in urban areas and just 9% in suburban areas. These figures only worsen in low and middle-income nations and resource-limited settings, where access to CT or MRI may simply not be possible.
Most would agree medical imaging must be more accessible to address inequalities in healthcare. Overcoming these disparities and improving access requires a new, technology-driven approach that makes imaging more affordable, faster, available at point of care and ultimately, more accessible.
Looking specifically at stroke intervention, time, and the tyranny of distance to a hospital is certainly a barrier to time-critical diagnosis and treatment and can mean the difference between recovery and permanent disability. To tackle this, a key solution is portable neuroimaging.
The adoption of portable neuroimaging innovations, which can be brought to the patient, will be indispensable, particularly for those living in rural or remote communities and might suffer a stroke.
Supporting radiology specialists
It’s not only about reducing barriers to physical imaging technology, patients also need access to the expertise of radiologists who can read medical imaging and treat patients accordingly.
In the US, there are more than 36,000 radiologists. However, in a country of 43 million, Kenya has just 200 radiologists. Liberia has only two. With skills shortages gripping healthcare systems around the world, innovation in portability, AI decision support and telemedicine can play a pivotal role in streamlining the sharing of vital information, supporting teams, and improving staff wellbeing.
Portable imaging technology can be adopted bedside, in space limited environments like intensive care units, to unlock efficiencies in triage settings and assist radiologists and technicians in decision making. The transportation of patients can be demanding on resources, put patients at risk and impact time to a critical clinical decision but the introduction of such technology removes these challenges and makes imaging accessible beyond hospital settings. Increasingly, AI-supported tools, whilst requiring further clinical validation for many applications, are showing fantastic promise to further help overcome healthcare gaps.
It’s evident that innovation in medical imaging is accelerating at a rapid pace. Ultimately, innovative portable and miniaturised imaging tools can play a vital role in improving stroke care and diagnosis and embracing these technologies will play a significant role in diminishing inequalities in our global healthcare system.
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