A world-first study at Monash University has used Google map data to locate the hospitals to which patients with stroke should be transported for urgent and highly specialised treatment.
While stroke is a leading cause of death and disability worldwide, recent major advances in acute stroke management, such as endovascular clot retrieval (ECR), are bringing optimism to patients, their families and stroke clinicians. ECR is a specialised procedure that is adopted to remove the clot blocking the affected artery in order to limit damage to the brain. A time-critical treatment, it requires highly skilled stroke teams, and is only available at a limited number of tertiary hospitals.
Published in the prestigious journal Stroke, the study was led by Monash University’s Professor Thanh Phan, who said the best outcomes for patients with stroke are achieved by rapid transport to hub hospitals designated to provide expert ECR treatment.
“Our team used Google map live data to decide the best distribution of patient transfers in Victoria,” said Professor Phan, who is a neurologist at Monash Health.
“In order to achieve the best outcomes for patients, we must objectively determine the areas a hub hospital can service so that ambulance personnel can make correct and quick decisions when transporting a person who has suffered a stroke. Our findings show that the combination of Monash Medical Centre and Royal Melbourne Hospital provides the best coverage for patients in Melbourne with regards to optimal transport time to hospital.”
“For the first time, we’ve developed new computational methods to access Google map data to reliably and objectively generate service boundaries for ECR hubs, defined by optimal traveling time to the hub,” said Professor Phan.
Senior co-author Velandai Srikanth, Professor of Medicine at Peninsula Health and the Peninsula Clinical School, Monash University said the data-driven method can be interactively applied at various times of the day, depending on traffic conditions, and removes any personal bias.
“This study has opened up the exciting possibility of real-time decision-making in efficient and rapid health care delivery for patients with acute stroke.”
This research is novel because the current use of ambulance transport data only provides traveling time to a hospital, and cannot be used to provide data on hospital catchment boundaries.
“The Google Map Application Programming Interface (API) allowed us to simulate travel from one location to multiple hospitals, enabling us for the first time to reliably simulate several real-time scenarios and generate optimal hub catchments,” said co-author Associate Professor Richard Beare, Head of Imaging and Bioinformatics at Peninsula Clinical School, Monash University.
The research team calculated transport times to four ECR capable Melbourne hospitals from simulated addresses at four different times of day—8.15am, 12.30pm. 5.15pm and 1am – and used the best case scenario traffic model to approximate emergency ambulance transit.
To validate their model with real patient travel time data, the team compared their Google map time estimates with actual ambulance travel times for patients with stroke and found a very close correlation.
Head of Stroke at Monash Health Associate Professor Henry Ma said these simulated models can be used to identify the ideal hub for patient transfer.
"We can also model and display the impact of traffic conditions on travel time and the catchment areas to hospital by generating interactive maps,” said Associate Professor Ma, co-author on the study.
“These maps can guide ambulance personnel in real-time identification of routes to the nearest ECR hub.”
“This approach is potentially applicable in other metropolitan cities in Australia and overseas when designing ECR services, or indeed other acute time-dependent conditions such as acute coronary syndrome,” said Associate Professor Ma.
The interactive maps developed by the research team can be viewed at https://gntem2.github.io/Google-Map-to-Victorian-ECR-Hospitals/
Monash Medical Centre will come online as the second statewide ECR centre later—The Royal Melbourne Hospital is already operating in this capacity.