Pi-Shan Sung, Doctor & Clinical Associate Professor, Dept. of Neurology

Reperfusion therapy, such as endovascular thrombectomy (EVT) or intravenous thrombolysis, during the golden period window for acute ischemic stroke treatment can significantly improve patient outcomes. EVT, in particular, offers substantial benefits for patients with large vessel occlusions. However, due to the limited availability of EVT-trained physicians, not all emergency hospitals are equipped to provide this treatment. Current referral methods, such as phone calls or Line App, often suffer from delays, insufficient cross-institutional communication, and data security concerns.
To address these issues, the Stroke Center at National Cheng Kung University Hospital (NCKUH), in collaboration with the Institute of Biomedical Engineering at National Cheng Kung University (NCKU), launched the EVT transferring system (EVTTS) in early 2020—an innovative platform designed to improve communication and coordination within the regional stroke care network. EVTTS is a web-based system accessible via both computers and mobile devices. It enables medical staff to quickly input essential clinical information about stroke patients, requiring only 2-3 minutes to complete a referral. EVTTS directly provides the referring physician with the contact details of the receiving hospital's decision-making doctor, minimizing communication barriers and referral delays.
After developing the prototype in late 2020, EVTTS officially went live in October 2021 in partnership with hospitals across the Tainan-Chiayi region. By 2024, the network had expanded to include 19 hospitals, forming a secure, multi-directional, and highly responsive stroke referral system. Compared with traditional referral methods, EVTTS has demonstrated substantial improvements: it reduced referral time by 77 minutes, increased the thrombectomy rate by 26%, shortened the time to EVT by 128 minutes, and improved the rate of favorable outcomes in thrombectomy patients by 36.6%. It has also contributed to shorter hospital stays and reduced medical expenses for referred patients.

By addressing real-world referral needs, EVTTS enables referring hospitals to connect with thrombectomy-capable hospitals within the region. This innovative platform strengthens collaborative care among regional hospitals and enhances the quality of acute stroke referral and treatment.