Mobile access to medical images improves care of acute stroke patients

Decision regarding around-the-clock readiness

The SUS project to give physicians remote access to CT brain images for emergency stroke patients was initiated in autumn 2016. For a trial period, the hospital introduced around-the-clock readiness for emergency neuro interventional conditions, particularly treatment of acute ischemic stroke for neuro radiologists performing thrombectomies.

Only a few people were assigned the task of handling this 24/7 emergency duty for a group of patients where quick decisions are crucial. There was a need for instant access to image exams, regardless of which hospital conducted the exam.

Initially, the physician on call for the weekend brought home a laptop to quickly access the radiology exams and submit the reports to the neurologist for faster patient turnaround times. However, the laptops created limitations for the neuro interventionalist. The computers were perceived as laborious to carry around, and not optimal to use outside of their homes with connections on friends’ or public wireless networks. Moreover, sudden updates of virus protection software on the laptop—sometimes taking several minutes—could force the physician to rush back to the hospital to be able to view the images.

Sectra UniView supports the neurologist’s goals

“After many meetings and suggestions on how to streamline and make on-call duty even more effective, we decided to try mobile devices,” says Christer Kristiansson, PACS Administrator at Region Skåne. “We tested different tablets and finally decided to use iPad minis with SIM cards for 4G broadband and Wi-Fi.” SUS, which was already using the Sectra PACS, could now start using Sectra UniView, developed to fit touch tablets and allow users to search patients and show images with scrolling, zooming, etc.

Kristiansson goes on to explain that the system was up and running in March 2017, following tests and brief training in how to use and manage the application. Since then, no problems or lack of access to radiology exams have been reported, except one time—following an upgrade of the PACS and the UniView. After a quick firewall configuration, everything was soon working smoothly again.

Patient integrity in focus

Patient integrity was another important aspect for SUS when deciding to give physicians access to patient information and images outside the hospital premises. Sectra UniView requires password login, generating a one-time password that is sent to the user’s mobile phone. To ensure the connection is secure, access to Sectra UniView is made over a VPN—enabling secure image reviews outside Region Skåne’s firewalls.

Sectra UniView uses a “zero-footprint” web interface, leaving no patient information remaining on the mobile device once the application is turned off. This strengthens the security surrounding the patients’ integrity even further.

Great improvement potential for other departments

Dr. Johan Wasselius, a neuro radiologist at SUS in Lund who now uses UniView, says: “I would say that the introduction of tablets in our organization has had a powerful impact in general. We can now connect quickly and, within only a few minutes, submit a response determining the continued handling of the patient. The time savings are huge with this procedure, which benefits each individual patient. And a larger portion of the treated population is becoming functionally independent, which is one measure of success.”

Dr. Per Undrén and Dr. Birgitta Ramgren, also neuro radiologists in Lund, agree with Wasselius and add: “All forms of back-up, on-call radiology duty, where the clinicians review and act upon radiology images, could be optimized and benefit similarly from the technology. A few examples are cardiothoracic surgery, vascular surgery, neurosurgery, and orthopaedics.”

Christer Kristiansson summarizes the users’ reactions to the introduction of UniView: “Many users now say they simply cannot imagine being without their iPad with Sectra UniView.”