Introduction: There continues to be a lack of standard data management tools for neurovascular service lines and stroke programs. Many hospitals use “home grown” spreadsheets or upload to various registries which are designed more toward research initiatives than daily operations.
Hypothesis: Installation of a dedicated Neurovascular Information System (NVIS) will result in improved efficiency, quality, and financial performance in operating a stroke program and/or neurovascular service line.
Methods: A large health system in Tennessee installed an NVIS for daily use within its Comprehensive Stroke Center. The NVIS was designed to support automated data entry by front line care givers and capture clinical data for initial patient evaluation. This standardized data set is used to create an auto-generated neurologic consult report that posts to the patient record. The system is utilized through mobile technology, such as tablets and static monitoring units in identified key locations.
Data related to post discharge follow up referrals and visits to the neurology clinic, sleep lab, and cardiology clinic are also captured. Personnel from post-discharge clinics query the data base to assure patients receive appropriate follow up testing and care across the broader care delivery system. The staff is matching financial and post-discharge results with clinical markers to derive cost-benefit benchmarks.
Results: Data collection and reporting systems have provided efficiencies for neurology caregivers. Neuroconsults are auto generated by the NVIS while the patient is on the table in the CT scanner and discrete data fields are then uploaded to national databases. The health system increased its capture of downstream testing for the stroke population. Stroke patient visits to these follow up clinics/services have increased by at least 50% from last year. Referral information recorded in NVIS documents indications for follow up and guides the post discharge clinician in scheduling appropriate tests in the right timeframe.
Conclusion: Utilization of a dedicated NVIS reversed the narrative related to stroke program management and allowed program leaders to use data to drive programmatic decisions and development to support care delivery processes.