Andrew Southerland: Robust broadband key to mHealth stroke assessment


A tablet-based video conferencing system set up in ambulances may prove as reliable as traditional bedside assessments, and is a cheaper and faster option.

For the study, published in Neurology, reseachers used bidirectional videoconferencing and  4G LTE broadband in emergency vehicles during simulated stroke scenarios to communicate with a neurologist for stroke assessment

But more research is needed, says study author Andrew M. Southerland, M.D., assistant professor of neurology and public health sciences neurology residency program director, University of Virginia Health System.

Southerland spoke with FierceMobileHealthcare about the study, the challenges researchers faced and what he sees for the future of mHealth innovation.

FierceMobileHealthcare: What was the reaction to the study results, any surprises there?

Andrew M. Southerland: I felt that with good connectivity and video transmission we would be able to perform an accurate neurological assessment. We know this from traditional forms of telemedicine and telestroke care.  However, I was surprised by how well our mobile prehospital assessments correlated to an in-person hospital examination, simply because of all the obstacles one would expect with achieving high quality video transmission in a moving ambulance.

FMH: How did you choose the locations for the pilot?

Southerland: We chose central Virginia (University of Virginia) and the Bay Area (University of California, San Francisco) as locations where investigators in neurology and emergency medicine were already developing the concept of ambulance-based telemedicine in acute stroke care. We also wanted to target emergency medical services representative of both rural and suburban geography. These locations are hopefully representative of other health systems and regions.

FMH: Are there challenges tousing mHealth technology for these kind of assessments?

Southerland: We really wanted to keep our technology portable, utilitarian and low-cost. The challenges of implementing mHealth in prehospital stroke care are not necessarily the hardware, but the robust broadband necessary to make it useful. We spent two years mapping and refining connectivity along our ambulance routes before we were ready for actual patient assessments. Implementing prehospital telemedicine in other health systems would require a similar degree of rigor to ensure high-quality connectivity and clinical reliability.

FMH: The conclusion notes further research is needed. What would that focus on?

Southerland: Our pilot study incorporated simulated stroke scenarios. Clearly the next steps in our research are to verify feasibility in live patient encounters for acute neurological assessment. We are currently underway with this and hope to have initial results by 2017. Moreover, this is an exciting time for acute stroke care with new, life-saving treatments available. Fresh research is being done each day.  More than ever, we can envision the value of earlier diagnosis, triage, and treatment via prehospital telemedicine. We are hoping to expand the study in a multicenter clinical trial where we can better see how easily our system could be implemented to other health systems and communities around the country.

Editor's Note: This interview has been edited for clarity and length.