The impact of super-charged stroke care

Research innovations within the health sector will only succeed if they can prove their impact.  Our Evaluation Platform lead, Professor Dominique Cadilhac, says it’s critical to ask two questions:

How will a new model of care impact the health system?

How will the intervention improve the lives of patients?

As health interventions go, the research underway at the Australian Stroke Alliance is certainly disruptive, aiming to transform lives by dramatically improving the time it takes to reach and treat patients with stroke, regardless of location.

The Australian Government has invested $40 million in our work, partly influenced by the success of the interventions provided by staff on the mobile stroke unit (MSU) in Melbourne. A backbone of this team’s success is the careful collection of data and assessment of patient outcomes.

Photograph by Chris Hopkins

According to our Evaluation Platform lead, Professor Dominique Cadilhac: “When we evaluated the MSU, there was no time to do a randomised trial. We collected data during the first 18 months of it becoming operational and compared this with information regarding stroke outcomes from before it was implemented,” Dominique says.  As a result, many of the achievements of the MSU have been shared with the international MSU community. Data on MSUs from around the world augurs well for the Stroke Alliance’s mission.

Melbourne’s mobile stroke unit is changing lives:

  • We take the hospital to the patient – some 2200 have been assessed for stroke
  • Patients with stroke are treated 75 mins faster when compared to the Australian national median time
  • The MSU is able to treat patients in as little as 16 mins after arriving on scene
  • We treat 10 times as many patients in the Stroke Golden Hour compared to the standard hospital pathway
  • On average, it takes just 17 minutes from our arrival to the patient receiving a CT scan in the back of the ambulance
  • Paramedics are ready for the next patient 13% faster.

In her role with the Australian Stroke Alliance, Dominique will capture data to evaluate the impact of our super-charged pre-hospital stroke care.  These research projects will “estimate the potential health economic implications of the new technologies”.

“It’s important to estimate the potential costs and benefits to society with the implementation of pre-hospital models of care and new technologies. This will include an economic evaluation of a stroke air ambulance serving remote communities and stroke-capable road ambulances with on-board imaging and data transmission to regional hospitals.”

This process is already well on the way with Dominique and her team publishing the first data linkage with Ambulance Victoria, government data, and the Australian Stroke Clinical Registry where she is the data custodian.  This initial study provides great confidence on how data can be used for the evaluation of our innovations to come.

Establishing a health economics platform is a critical element of our overall program, according to Stroke Alliance CEO, Dr Henry De Aizpurua.

Without it we wouldn’t be able to measure the long-term impacts of our new models of care. It’s a superb example of research translation in action. Time-saving in the earlier treatment of stroke, at scale and nationally implemented, has the potential to save the Australian economy billions per annum. This work will lay the foundations so we are able to influence future health policy and investment.
CEO, Dr Henry De Aizpurua

One of the biggest misconceptions about this type of work is that many people believe that there needs to be evidence showing that the new approach saves money.  However, Dominique explains that this isn’t necessarily the case.

“It doesn’t mean everything has to be a cost-saving. It is justified to spend money on health and innovation in health, so long as the health benefits are justified over and above what is being invested.”

As well as being our evaluation platform lead, Dominique also heads the Translational Public Health and Evaluation Research Division in Stroke and Ageing Research in the School of Clinical Sciences at Monash University. She is also the Head of Public Health for stroke at the Florey Institute of Neuroscience and Mental Health.