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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

  • 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) ;
  • Sun Jeong Kim (Department of Convergence Software, Hallym University) ;
  • 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) ;
  • In Bok Chang (Department of Neurosurgery, Hallym University College of Medicine) ;
  • Jeong Jin Park (Department of Neurology, Konkuk University Medical Center) ;
  • Jong-Kook Rhim (Department of Neurosurgery, Jeju National University College of Medicine) ;
  • Sung-Chul Jin (Department of Neurosurgery, Inje University Haeundae Paik Hospital) ;
  • Sung Min Cho (Department of Neurosurgery, Yonsei University Wonju College of Medicine) ;
  • Sung-Pil Joo (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Seung Hun Sheen (Department of Neurosurgery, CHA Bundang Medical Center, CHA University) ;
  • Sang Hyung Lee (Department of Neurosurgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine)
  • Received : 2023.09.16
  • Accepted : 2023.10.23
  • Published : 2024.07.01

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 decades. The available reporting ICH guidelines are realistically applicable 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.

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, RS-2022-00155659).

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