The network of Shanghai Stroke Service System (4S): A public health-care web-based database using automatic extraction of electronic medical records

Yi Dong, 1 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Kun Fang, 1 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Xin Wang, 2 Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shengdi Chen, 3 Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China.
Xueyuan Liu, 4 Department of Neurology, Shanghai Tenth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuwu Zhao, 5 Department of Neurology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yangtai Guan, 6 Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Dingfang Cai, 7 Department of Neurology, Shuguang Hospital Affiliated to University of Chinese Medicine, Shanghai, China.
Gang Li, 8 Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China.
Jianmin Liu, 9 Department of Neurology, Shanghai Changhai Hospital, Shanghai, China.
Jianren Liu, 10 Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jianhua Zhuang, 11 Department of Neurology, Shanghai Changzheng Hospital, Shanghai, China.
Panshi Wang, 12 Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
Xin Chen, 12 Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
Haipeng Shen, 13 Department of Business and Economics, University of Hong Kong, Hongkong, China.
David Z. Wang, 14 Comprehensive Stroke Center at OSF SFMC, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.Follow
Ying Xian, 15 Medicine Clinical Research Institute, Duke University, Durham, North Carolina, USA.
Wuwei Feng, 16 Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
Bruce Cv Campbell, 17 Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
Mark Parsons, 18 Department of Neurology, John Hunter Hospital, University of Newcastle, Australia.
Qiang Dong, 1 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Document Type

Article

Abstract

Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area. The 4S registry uses a web-based database that automatically extracts data from structured electronic medical records. Site-specific education and training program will be designed and administrated according to their baseline characteristics. Both acute reperfusion therapies including thrombectomy and thrombolysis in the acute phase and subsequent care were measured and monitored with feedback. Primary outcome is to evaluate the differences in quality metrics between baseline characteristics (including rate of thrombolysis in acute stroke and key performance indicators in secondary prevention) and post-intervention. Conclusions The 4S system is a regional stroke network that monitors the ongoing stroke care quality in Shanghai. This project will provide the opportunity to evaluate the spectrum of acute stroke care and design quality improvement processes for better stroke care. A regional stroke network model for quality improvement will be explored and might be expanded to other large cities in China. Clinical Trial Registration-URL http://www.clinicaltrials.gov . Unique identifier: NCT02735226.

Medical Subject Headings

China (epidemiology); Delivery of Health Care; Electronic Health Records; Female; Humans; Information Systems; Male; Quality Improvement; Registries; Stroke (epidemiology, therapy); Thrombectomy (methods, statistics & numerical data)

Publication Date

7-1-2018

Publication Title

International journal of stroke : official journal of the International Stroke Society

E-ISSN

1747-4949

Volume

13

Issue

5

First Page

539

Last Page

544

PubMed ID

29561219

Digital Object Identifier (DOI)

10.1177/1747493018765492

Link to Full Text

Share

COinS