DOI QR코드

DOI QR Code

Development of Cloud-Based Telemedicine Platform for Acute Intracerebral Hemorrhage in Gangwon-do : Concept and Protocol

  • Hyo Sub Jun (Department of Neurosurgery, Kangwon National University Hospital) ;
  • Kuhyun Yang (Department of Neurosurgery, GangNeung Asan Hospital) ;
  • Jongyeon Kim (Department of Neurosurgery, Yonsei University Wonju College of Medicine) ;
  • Jin Pyeong Jeon (Department of Neurosurgery, Hallym University College of Medicine) ;
  • Jun Hyong Ahn (Department of Neurosurgery, Kangwon National University Hospital) ;
  • Seung Jin Lee (Department of Neurosurgery, Kangwon National University Hospital) ;
  • Hyuk Jai Choi (Department of Neurosurgery, Hallym University College of Medicine) ;
  • Jong Wook Choi (Department of Neurosurgery, Yonsei University Wonju College of Medicine) ;
  • Sung Min Cho (Department of Neurosurgery, Yonsei University Wonju College of Medicine) ;
  • Jong-Kook Rhim (Department of Neurosurgery, Jeju National University College of Medicine)
  • Received : 2022.11.25
  • Accepted : 2023.02.06
  • Published : 2023.09.01

Abstract

We aimed to develop a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local hospitals in rural and underserved areas in Gangwon-do using artificial intelligence and non-face-to-face collaboration treatment technology. This is a prospective and multi-center development project in which neurosurgeons from four university hospitals in Gangwon-do will participate. Information technology experts will verify and improve the performance of the cloud-based telemedicine collaboration platform while treating ICH patients in the actual medical field. Problems identified will be resolved, and the function, performance, security, and safety of the telemedicine platform will be checked through an accredited certification authority. The project will be carried out over 4 years and consists of two phases. The first phase will be from April 2022 to December 2023, and the second phase will be from April 2024 to December 2025. The platform will be developed by dividing the work of the neurosurgeons and information technology experts by setting the order of items through mutual feedback. This article provides information on a project to develop a cloud-based telemedicine platform for acute ICH patients in Gangwon-do.

Keywords

Acknowledgement

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number : 1711179390, RS2022-00155659). Our Gangwon-do Council of Neurosurgeons is very grateful to Jae Jun Lee (Professor, Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine), Chulho Kim (Associated Professor, Department of Neurology, Hallym University College of Medicine), and Youngmi Kim (Research Professor, Institute of New Frontier Research, Hallym University College of Medicine). We would also like to thank Professor Seung Hun Sheen (Department of Neurosurgery, CHA Bundang Hospital) for providing the idea of telemedicine for ICH patients. Our concept will be conducted as a prospective and multicenter study using clinical registry data after IRB approval of each university hospital.

References

  1. Ahn JH, Kim HC, Rhim JK, Park JJ, Sigmund D, Park MC, et al. : Multi-view convolutional neural networks in rupture risk assessment of small, unruptured intracranial aneurysms. J Pers Med 11 : 239, 2021
  2. An SJ, Kim TJ, Yoon BW : Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update. J Stroke 19 : 3-10, 2017 https://doi.org/10.5853/jos.2016.00864
  3. Arbabshirani MR, Fornwalt BK, Mongelluzzo GJ, Suever JD, Geise BD, Patel AA, et al. : Advanced machine learning in action: identification of intracranial hemorrhage on computed tomography scans of the head with clinical workflow integration. NPJ Digit Med 1 : 9, 2018
  4. Brouwers HB, Greenberg SM : Hematoma expansion following acute intracerebral hemorrhage. Cerebrovasc Dis 35 : 195-201, 2013 https://doi.org/10.1159/000346599
  5. Cho KC, Kim H, Suh SH : Trends in mortality from hemorrhagic stroke in Korea from 2012 to 2020. Neurointervention 17 : 87-92, 2022 https://doi.org/10.5469/neuroint.2022.00220
  6. Cooley SR, Zhao H, Campbell BCV, Churilov L, Coote S, Easton D, et al. : Mobile stroke units facilitate prehospital management of intracerebral hemorrhage. Stroke 52 : 3163-3166, 2021 https://doi.org/10.1161/STROKEAHA.121.034592
  7. El Naamani K, Abbas R, Mukhtar S, El Fadel O, Sathe A, Kazan AS, et al. : Telemedicine during and post-COVID 19: the insights of neurosurgery patients and physicians. J Clin Neurosci 99 : 204-211, 2022 https://doi.org/10.1016/j.jocn.2022.03.006
  8. Hong KS, Bang OY, Kim JS, Heo JH, Yu KH, Bae HJ, et al. : Stroke statistics in Korea: part II stroke awareness and acute stroke care, a report from the Korean Stroke Society and Clinical Research Center For Stroke. J Stroke 15 : 67-77, 2013 https://doi.org/10.5853/jos.2013.15.2.67
  9. Huttner HB, Gerner ST, Kuramatsu JB, Connolly SJ, Beyer-Westendorf J, Demchuk AM, et al. : Hematoma expansion and clinical outcomes in patients with factor-Xa inhibitor-related atraumatic intracerebral hemorrhage treated within the ANNEXA-4 trial versus real-world usual care. Stroke 53 : 532-543, 2022 https://doi.org/10.1161/STROKEAHA.121.034572
  10. Im SI : What regional disparity trends of cardiovascular mortality have changed in 2019 compared to the 1980s? Korean Circ J 52 : 844-846, 2022 https://doi.org/10.4070/kcj.2022.0276
  11. Kane-Gill SL, Rincon F : Expansion of telemedicine services: telepharmacy, telestroke, teledialysis, tele-emergency medicine. Crit Care Clin 35 : 519-533, 2019 https://doi.org/10.1016/j.ccc.2019.02.007
  12. Kim HC, Rhim JK, Ahn JH, Park JJ, Moon JU, Hong EP, et al. : Machine learning application for rupture risk assessment in small-sized intracranial aneurysm. J Clin Med 8 : 683, 2019
  13. Kuohn LR, Witsch J, Steiner T, Sheth KN, Kamel H, Navi BB, et al. : Early deterioration, hematoma expansion, and outcomes in deep versus lobar intracerebral hemorrhage: the FAST trial. Stroke 53 : 2441-2448, 2022 https://doi.org/10.1161/STROKEAHA.121.037974
  14. Lee JY, Kim JS, Kim TY, Kim YS : Detection and classification of intracranial haemorrhage on CT images using a novel deep-learning algorithm. Sci Rep 10 : 20546, 2020
  15. Lee SU, Kim T, Kwon OK, Bang JS, Ban SP, Byoun HS, et al. : Trends in the incidence and treatment of cerebrovascular diseases in Korea : part I. Intracranial aneurysm, intracerebral hemorrhage, and arteriovenous malformation. J Korean Neurosurg Soc 63 : 56-68, 2020 https://doi.org/10.3340/jkns.2018.0179
  16. Liu J, Xu H, Chen Q, Zhang T, Sheng W, Huang Q, et al. : Prediction of hematoma expansion in spontaneous intracerebral hemorrhage using support vector machine. EBioMedicine 43 : 454-459, 2019 https://doi.org/10.1016/j.ebiom.2019.04.040
  17. Long J, He R, Tian S, Luo Y, Ma M, Wang W, et al. : Development and utility of a close contact information management system for the COVID-19 pandemic. BMC Public Health 21 : 2248, 2021
  18. McGurgan IJ, Ziai WC, Werring DJ, Al-Shahi Salman R, Parry-Jones AR : Acute intracerebral haemorrhage: diagnosis and management. Pract Neurol 21 : 128-136, 2020 https://doi.org/10.1136/practneurol-2020-002763
  19. Morotti A, Boulouis G, Dowlatshahi D, Li Q, Barras CD, Delcourt C, et al. : Standards for detecting, interpreting, and reporting noncontrast computed tomographic markers of intracerebral hemorrhage expansion. Ann Neurol 86 : 480-492, 2019 https://doi.org/10.1002/ana.25563
  20. Mukhtar H, Ahmad HF, Khan MZ, Ullah N : Analysis and evaluation of COVID-19 web applications for health professionals: challenges and opportunities. Healthcare (Basel) 8 : 466, 2020
  21. Rha JH, Koo J, Cho KH, Kim EG, Oh GS, Lee SJ, et al. : Two-year direct medical costs of stroke in Korea: a multi-centre incidence-based study from hospital perspectives. Int J Stroke 8 : 186-192, 2013 https://doi.org/10.1111/j.1747-4949.2012.00815.x
  22. Seyam M, Weikert T, Sauter A, Brehm A, Psychogios MN, Blackham KA : Utilization of artificial intelligence-based intracranial hemorrhage detection on emergent noncontrast ct images in clinical workflow. Radiol Artif Intell 4 : e210168, 2022