Digital Health-Enabled Prehospital Notification for Acute Stroke Using the Brain Saver Mobile App in Emergency Medical Transport in South Korea: Pilot Quasi-Experimental Study.
15 affiliations
- 1Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
- 2Department of Healthcare Policy Research, Korea Institute for Health and Social Affairs, Sejong, Republic of Korea.
- 3Community Health Innovation Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
- 4Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
- 5Medical Research Institute, Pohang Stroke and Spine Hospital, Pohang, Gyeongsangbuk-do, Republic of Korea.
- 6Department of Neurology, Pohang St. Mary's Hospital, Pohang, Gyeongsangbuk-do, Republic of Korea.
- 7Department of Neurology, Pohang Semyeong Christianity Hospital, Pohang, Gyeongsangbuk-do, Republic of Korea.
- 8Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea.
- 9Seers Technology Co, Ltd, Pyeongtaek, Gyeonggi-do, Republic of Korea.
- 10Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea.
- 11Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
- 12Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea.
- 13Medical Big Data Research Center, Seoul National University Medical Research Center, Seoul, Republic of Korea.
- 14Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
- 15BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
Background
Timely access to stroke care is critical for patient prognosis. Despite the growing use of digital health strategies in stroke management, evidence supporting seamless and timely care coordination from the emergency medical services (EMS) to the emergency department (ED) remains limited. Brain Saver, a newly developed mobile app, addresses this gap by facilitating real-time data sharing between EMS personnel and ED clinicians during stroke transport.Objective
This study aimed to examine the potential of the Brain Saver protocol to improve existing EMS-ED workflows in emergency stroke transport by describing its functional components, implementing a pilot intervention in a real-world setting, and exploring its preliminary impact on treatment timeliness.Methods
Data were collected in Pohang, South Korea, from December 2023 to April 2024 through collaboration with 2 fire stations, eight 119 EMS and safety centers, 3 hospitals, and SEERS Technology. Preintervention training and postintervention surveys were conducted among EMS personnel (n=80) and clinicians (n=24). In this pilot, patients with stroke (ICD-10 [International Classification of Diseases, Tenth Revision] codes I60-I63) in the intervention group (n=34) were transported using ambulances equipped with the Brain Saver mobile app, while the comparison group (n=129) was transported by standard ambulances to the same hospitals during the study period. With "needle" defined as any parenteral treatment, onset-to-door time and door-to-needle time were compared by group. After exact matching on age, baseline stroke severity, stroke type, and destination hospital, intervention effects were estimated using generalized estimating equations.Results
Participants (N=163) had a mean age of 69.4 (SD 15.2) years, 50.3% (82/163) were male, and 65.6% (107/163) had ischemic stroke. No significant baseline differences, including stroke severity, were observed between groups. The median onset-to-needle time was shorter in the intervention group than in the comparison group (114 vs 204 minutes; P=.03). In the matched analytic sample (n=91), the intervention group showed significant reductions in onset-to-needle time (Exp(β)=0.49; P=.009) and door-to-needle time (Exp(β)=0.67; P=.04) compared with the comparison group.Conclusions
Integrating digital health into emergency stroke transport may improve care timeliness by supporting real-time prehospital notification and facilitating prompt in-hospital responses. The Brain Saver mobile app shows potential use for reducing onset-to-treatment time. Further larger-scale studies are needed to evaluate implementation fidelity and scalability.
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BibTeX
@article{kim2026digital,
title = {{Digital Health-Enabled Prehospital Notification for Acute Stroke Using the Brain Saver Mobile App in Emergency Medical Transport in South Korea: Pilot Quasi-Experimental Study.}},
author = {Eunah Kim and Jeongheon Kim and Dougho Park and Suhyun Park and Byungju Lee and Mi Sun Oh and Taehee Kim and Jinhyang Kim and Gahui Gim and Joongyub Lee and Ji-Yeob Choi and Daehee Kang},
journal = {JMIR medical informatics},
year = {2026},
month = oct,
doi = {10.2196/92992},
url = {https://europepmc.org/article/MED/42849893},
note = {CC BY},
}
RIS
TY - JOUR
TI - Digital Health-Enabled Prehospital Notification for Acute Stroke Using the Brain Saver Mobile App in Emergency Medical Transport in South Korea: Pilot Quasi-Experimental Study.
AU - Eunah Kim
AU - Jeongheon Kim
AU - Dougho Park
AU - Suhyun Park
AU - Byungju Lee
AU - Mi Sun Oh
AU - Taehee Kim
AU - Jinhyang Kim
AU - Gahui Gim
AU - Joongyub Lee
AU - Ji-Yeob Choi
AU - Daehee Kang
PY - 2026
DA - 2026/10/08
JO - JMIR medical informatics
DO - 10.2196/92992
UR - https://europepmc.org/article/MED/42849893
AB - Background Timely access to stroke care is critical for patient prognosis. Despite the growing use of digital health strategies in stroke management, evidence supporting seamless and timely care coordination from the emergency medical services (EMS) to the emergency department (ED) remains limited. Brain Saver, a newly developed mobile app, addresses this gap by facilitating real-time data sharing between EMS personnel and ED clinicians during stroke transport.Objective This study aimed to examine the potential of the Brain Saver protocol to improve existing EMS-ED workflows in emergency stroke transport by describing its functional components, implementing a pilot intervention in a real-world setting, and exploring its preliminary impact on treatment timeliness.Methods Data were collected in Pohang, South Korea, from December 2023 to April 2024 through collaboration with 2 fire stations, eight 119 EMS and safety centers, 3 hospitals, and SEERS Technology. Preintervention training and postintervention surveys were conducted among EMS personnel (n=80) and clinicians (n=24). In this pilot, patients with stroke (ICD-10 [International Classification of Diseases, Tenth Revision] codes I60-I63) in the intervention group (n=34) were transported using ambulances equipped with the Brain Saver mobile app, while the comparison group (n=129) was transported by standard ambulances to the same hospitals during the study period. With "needle" defined as any parenteral treatment, onset-to-door time and door-to-needle time were compared by group. After exact matching on age, baseline stroke severity, stroke type, and destination hospital, intervention effects were estimated using generalized estimating equations.Results Participants (N=163) had a mean age of 69.4 (SD 15.2) years, 50.3% (82/163) were male, and 65.6% (107/163) had ischemic stroke. No significant baseline differences, including stroke severity, were observed between groups. The median onset-to-needle time was shorter in the intervention group than in the comparison group (114 vs 204 minutes; P=.03). In the matched analytic sample (n=91), the intervention group showed significant reductions in onset-to-needle time (Exp(β)=0.49; P=.009) and door-to-needle time (Exp(β)=0.67; P=.04) compared with the comparison group.Conclusions Integrating digital health into emergency stroke transport may improve care timeliness by supporting real-time prehospital notification and facilitating prompt in-hospital responses. The Brain Saver mobile app shows potential use for reducing onset-to-treatment time. Further larger-scale studies are needed to evaluate implementation fidelity and scalability.
SN - 2291-9694
ER -