J Korean Neurosurg Soc.  2024 Jul;67(4):385-396. 10.3340/jkns.2023.0199.

Telemedicine Protocols for the Management of Patients with Acute Spontaneous Intracerebral Hemorrhage in Rural and Medically Underserved Areas in Gangwon State : Recommendations for Doctors with Less Expertise at Local Emergency Rooms

• Jun HS
• Yang K
• Kim J
• Jeon JP
• Kim SJ
• Ahn JH
• Lee SJ
• Choi HJ
• Chang IB
• Park JJ
• Rhim JK
• Jin SC
• Cho SM
• Joo SP
• Sheen SH
• Lee SH
• on behalf of the Gangwon State Neurosurgery Consortium

• KMID: 2556736
• DOI: http://doi.org/10.3340/jkns.2023.0199

Abstract

Previously, we reported the concept of a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local emergency rooms in rural and medically underserved areas in Gangwon state by combining artificial intelligence and remote consultation with a neurosurgeon. Developing a telemedicine ICH treatment protocol exclusively for doctors with less ICH expertise working in emergency rooms should be part of establishing this system. Difficulties arise in providing appropriate early treatment for ICH in rural and underserved areas before the patient is transferred to a nearby hub hospital with stroke specialists. This has been an unmet medical need for decade. The available reporting ICH guidelines are realistically possible in university hospitals with a well-equipped infrastructure. However, it is very difficult for doctors inexperienced with ICH treatment to appropriately select and deliver ICH treatment based on the guidelines. To address these issues, we developed an ICH telemedicine protocol. Neurosurgeons from four university hospitals in Gangwon state first wrote the guidelines, and professors with extensive ICH expertise across the country revised them. Guidelines and recommendations for ICH management were described as simply as possible to allow more doctors to use them easily. We hope that our effort in developing the telemedicine protocols will ultimately improve the quality of ICH treatment in local emergency rooms in rural and underserved areas in Gangwon state.

Keyword

Intracerebral hemorrhage; Telemedicine; Cerebral hemorrhage; Treatment

Figure

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  Fig. 1. Telemedicine protocols for patients with acute intracranial hemorrhage (ICH) at local hospitals in the rural and medically underserved area in Gangwon state. The protocols we suggested intend to increase the treatment quality of the patients in those areas before their transfer to the nearby hub hospitals with stroke specialists, in particular neurosurgeons are available. SBP : systolic blood pressure, IV : intravenously, IICP : increased intracranial pressure.

Reference

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