AIIMS launches app to help physicians provide care to stroke patients

PTI, Oct 31, 2021, 5:21 PM IST

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The neurology department of the AIIMS has launched a mobile application, ‘SMART-India App’, as part of a research project aimed at helping physicians at district-level hospitals provide quality care to stroke patients.

“One of the major challenges is to deliver adequate healthcare in rural India where more than two-thirds of India’s population live. There is severe shortage of specialists in rural areas with one of the lowest physician/population ratios in the world,” Dr M V Padma Srivastava, chief of Neurosciences Centre at AIIMS, said.
There is only one neurologist per 1.25 million population.

Dr Vishnu V Y, Associate Professor of Neurology at AIIMS, said, “Two innovative solutions to this problem include training physicians at district hospital to diagnose and manage acute stroke (stroke physician model) or use low-cost telestroke model. We developed the SMART-India App with a primary purpose of providing a low-cost telestroke services of a neurologist and physiotherapist to physicians in district hospitals.”

Besides, two other stroke-related initiatives — IMPETUS and CARE-DAT — were also launched to improve the quality of life of disabled persons who have suffered a stroke through newer technological advances.
World Stroke Day is observed on October 29.

Centre for Advanced Research and Excellence in Disability and Assistive Technology (CARE-DAT) is a joint research project developed by AIIMS-New Delhi and the Indian Institute of Technology (IIT), Delhi to study the role of assistive technologies in optimizing functional recovery post stroke with special emphasis on hand function and its validation of sustenance and long-term clinical impact, said Dr Suhas Murali, who is doing stroke fellowship at AIIMS.

Stroke is the second leading cause of chronic disability and mortality with 102 million disability adjusted life years lost annually. The estimated adjusted prevalence rate of stroke reported a range of 84 to 262/1,00,000 population in rural and 334-424/1,00,000 in urban India, Dr Murali said.

Physiotherapy services post stroke are long term, costly and need resilience from both patients and therapists. The burden on hospitals is humongous to provide enough room and equipments for stroke patients.
The objectives of this research are to design low-cost exoskeleton and piezoelectric hand gloves for improvement of upper limb function after stroke and to develop virtual reality module and to evaluate the clinical impact on upper limb rehabilitation, Dr Srivastava said.

IMPETUS is an implementation research project that aims to investigate the feasibility of implementing a uniform stroke care pathway in medical colleges of India and improving stroke care, Dr Rohit Bhatia, Professor, Department of Neurology at AIIMS, said.

The study will be conducted in selected medical colleges across the country and is intended to examine the changes in a select set of stroke care related indicators over time within the sites exposed to the same implementation strategy.

During the implementation phase, education and training about the standard stroke care pathway will be provided to all stakeholders of implementing sites.

Patient level outcomes will be collected throughout the study. The first-of-its-kind study aims to implement a thoroughly designed package of stroke interventions, including recognition and triaging in emergency, rapid and timely evaluation and treatment, stroke etiological evaluation, in-hospital care, patient education, caregiver mentoring and adequate secondary prevention strategies and rehabilitation in medical colleges, Dr Bhatia said.Since the number of neurologists are limited and medicine specialists play a vital role in medical colleges, this study is the first-of-its-kind systematic effort to train non-neurology medical specialists in medical colleges towards optimized acute stroke care. This is the first of the study to help strengthen skilled and trained manpower in medical colleges to impart best available stroke care to patients, Dr Bhatia said.

The study will help generate evidence on practicalities of implementing the uniform standard stroke care pathways across various medical colleges, he said.