Stroke Management as a Service - a Distributed and Mobile Architecture for Post-Acute Stroke Management

Stroke is the second leading cause of death for people older than 60 and the most common cause of disability for adults worldwide, which leads to enormous societal healthcare costs. In contrast to acute stroke treatment, the improvement of the complex processes during the post-acute stroke treatment in a regional healthcare service network (HSN) did not receive much attention. Currently, there are no post-acute stroke care management approaches in Germany that exploit the advantages of information technology even though it is one of the most expensive diseases. Unfortunately, chronic care concepts of other diseases cannot easily be transferred. Therefore, we investigated the state-of-the-art postacute stroke workflows, identified requirements for a general architecture that supports the current post-acute stroke management and developed a novel stroke manager service according to the requirements using a combined service engineering and software engineering approach. The contribution of this paper is threefold: It lists requirements for an effective post-stroke management, describes the complex inter-institutional workflow of a novel stroke manager service and presents a prototypically implemented stroke manager architecture. The requirements and the stroke manager service as well as the architecture have been evaluated by domain experts.