This app has been jointly developed by stroke consultants in the Nuffield Department of Clinical Medicine ( http://www.ndm.ox.ac.uk ) and researchers in the Institute of Biomedical Engineering in Oxford ( http://www.ibme.ox.ac.uk ).
Stroke Nav is a web-based system which supports clinicians and managers involved in stroke care. Users can enter and review data via tablets such as the Apple iPad. The system offers data collection modules for each aspect of treatment, including multidisciplinary team meetings, handover lists, therapy assessments and goal planning. Where possible, the modules share data to avoid duplication. The information is transferred seamlessly between acute and rehabilitation hospitals, and between different disciplines within the multidisciplinary care team, supporting continuity of care. The system has also been designed with nationally-collected metrics in mind and provides automatic calculation of key metrics, as well as ad hoc analyses, offering a real-time graphical dashboard of service performance.
The primary function of Stroke Nav is to facilitate and standardise the collection of data relating to stroke patients. Stroke Nav also provides the following benefits:
- The real-time auditable stroke patient record can be used across the stroke pathway.
- Built-in algorithms encourage clinicians to follow guidelines and standard operating procedures, with automatic calculation of scores such as the National Institutes of Health Stroke Scale and Glasgow Coma Scale. The system also highlights contraindications against treatments such as thrombolysis.
- Stroke patients usually receive multiple phases of care from a range of disciplines (including doctors, physiotherapists, nurses, occupational therapists and others). Stroke Nav helps to reduce duplication and promote the seamless transfer of information between these groups. For example, Stroke Nav shares common information between the initial occupational therapy and physiotherapy assessments.
- Data can be accessed from multiple hospitals, allowing continuity of care for patients who are transferred between acute and rehabilitation settings.
- The development has been led by clinicians, allied healthcare professionals and engineers, and integrates with day-to-day routinely collected clinical information. Features such as focused goal setting and progress reporting support clinical care without extra workload.
- Training is supported (for example in the use of validated clinical scoring / stratification systems).
- Accurate, timely and concise information is provided for clinical audit and governance purposes. Documents can be stored and viewed within the system (such as induction information and ward protocols). The real-time dashboard allows early recognition of governance issues and the effects of implementing changes.
Stroke Nav has been in routine clinical use in Oxford Radcliffe Hospitals, as well as the community and home rehabilitation settings, for over 18 months, with over 1400 patients registered. It is also being piloted at Milton Keynes Hospital.
The results of the clinical use of Stroke Nav have been presented at a number of conferences. Copies of these presentations are available at http://www.ibme.ox.ac.uk/bsp/research/healthcare-apps .