The Effects of Integrated IT Support on the Prehospital Stroke Process: Results from a Realistic Experiment
Artikel i vetenskaplig tidskrift, 2019

Stroke is a serious condition and the stroke chain of care is a complex. The present study aims to explore the impact of a computerised decision support system (CDSS) for the prehospital stroke process, with focus on work processes and performance. The study used an exploratory approach with a randomised controlled crossover design in a realistic contextualised simulation experiment. The study compared clinical performance among 11 emergency medical services (EMS) teams of 22 EMS clinicians using (1) a computerised decision support system (CDSS) and (2) their usual paper-based process support. Data collection consisted of video recordings, postquestionnaires and post-interviews, and data were analysed using a combination of qualitative and quantitative approaches. In this experiment, using a CDSS improved patient assessment, decision making and compliance to process recommendations. Minimal impact of the CDSS was found on EMS clinicians’ self-efficacy, suggesting that even though the system was found to be cumbersome to use it did not have any negative effects on self-efficacy. Negative effects of the CDSS include increased on-scene time and a cognitive burden of using the system, affecting patient interaction and collaboration with team members. The CDSS’s overall process advantage to the prehospital stroke process is assumed to lead to a prehospital care that is both safer and of higher quality. The key to user acceptance of a system such as this CDSS is the relative advantages of improved documentation process and the resulting patient journal. This could improve the overall prehospital stroke process.

Prehospital process

Decision support

EMS team



M. A. Hagiwara

Högskolan i Borås

Lars Lundberg

Högskolan i Borås

Bengt-Arne Sjöqvist

Chalmers, Elektroteknik, Signalbehandling och medicinsk teknik

Hanna Maurin Söderholm

Högskolan i Borås

Journal of Healthcare Informatics Research

2509498X (eISSN)

Vol. 3 3 300-328


Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi





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