Abstract
Background: UCHealth's Mobile Stroke Unit (MSU) at University of Colorado Hospital is an ambulance
equipped with a computed tomography (CT) scanner and tele-stroke capabilities that
began clinical operation in Aurora, Colorado January 2016. As one of the first MSU's
in the United States, it was necessary to design unique and dynamic information technology
infrastructure. This includes high-speed cellular connectivity, Health Insurance Portability
and Accountability Act compliance, cloud-based and remote access to electronic medical
records (EMR), and reliable and rapid image transfer. Here we describe novel technologies
incorporated into the MSU. Technological data-handling aspects of the MSU were reviewed.
Functions evaluated include wireless connectivity while in transit, EMR access and
manipulation in the field, CT with image transfer from the MSU to the hospital's Picture
Archiving Communication System (PACS), and video and audio communication for neurological
assessment. Methods/Results: The MSU wireless system was designed with redundancy to avoid dropped signals during
data transfer. Two separate Internet Protocol destinations with split-tunnel architecture
are assigned, for videoconferencing and for EMR data transfer. Brain images acquired
in the ambulance CT scanner are transferred initially to an onboard laptop, then via
Citrix Receiver to the hospital-based PACS server where they can be viewed in PACS
or EMR by the stroke neurologist, neuroradiologist, and other providers. PACS and
Radiology Information System are 2 of the XenApps utilized by CT technologists on
board the MSU. Discussion/Conclusions: These technologies will serve as a blueprint for development of similar units elsewhere,
and as a framework for improvement in this technology.
Key Words
Subject Terms
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Article info
Publication history
Published online: July 12, 2019
Accepted:
June 7,
2019
Received:
April 15,
2019
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.008
Copyright
© 2019 Published by Elsevier Inc.
