A.I. for stroke: Surgical decisions now resolved in Cloud

HARLINGEN — It’s 2 a.m.

Dr. Ameer Hassan, at one moment sound asleep, suddenly awakens to a loud beep coming from his phone.

He sits straight up, opens the V-shaped VizNet app on his phone, and a patient’s CT angiogram appears.

The words “LVO suspected,” appear and its time to go to work. LVO stands for large vessel occlusion, which is a blood clot in the brain. The patient is having a stroke and needs help fast.

Variants of this hypothetical scenario have played out numerous times since the new system came into use in November at Valley Baptist Medical Center in Harlingen.

“It operates in Cloud,” said Hassan, head of the neuroscience department at Valley Baptist.

“Basically it takes the images once the CAT scan is done, and they’re pushed from the system to their servers on the cloud,” he said. “It’s a cloud-based artificial intelligence. The idea behind that is so you can do constant upgrades to the algorhythms so that you continue to improve.”

Ah, but there’s more to it than that. Before, the process of stroke treatment required first the radiologist to check the images.

“It would take them about an hour to get a read from a radiologist,” Hassan said. “The radiologist would then call the emergency room doctor, who then calls Dr. Luis Gaitan, who then calls me to find out whether or not I’m willing to accept the patient.”

If there’s a blood clot, the patient will need a mechanical thrombectomy to remove it, which is done at Valley Baptist in Harlingen. Otherwise, they can be treated with an IV solution at other hospitals. In this case, Valley Baptist Harlingen is a hub location, and other locations such as Brownsville is considered a spoke.

With stroke, minutes can mean the difference of a life of mobility, or incapacity, or even death. So VizNet reduces that time and increases efficiency.

With the new cloud system, everyone — Hassan and fellow endovascular neurologist Wondwossen Tekle, plus stroke coordinators, research coordinators, neurohospitalists and neurocritical doctors — all receive the alert at the same time.

“We’re not waiting an hour anymore for the radiologist to read the CAT scans,” Hassan said. “That patient is already in an ambulance, already en route probably to our hospital, before the radiologist in Brownsville has even read it yet.”

This cuts down on the time needed to treat the stroke by more than 30 minutes.

“Now I get the alert, for example if it’s in the middle of the night, I’m calling the house supervisor directly and saying, ‘transfer the patient’ versus going through that whole chain of phone calls,” he said. “I’m bypassing radiology and even the physician at the transfer center.”

Hassan said 15 successful cases have been transferred from Valley Baptist Brownsville to Harlingen for treatment.

“Probably three times as many have been screened and stayed at Valley Baptist Brownsville,” he said.

“They stay close to their families. They didn’t have to be transferred. These primary stroke centers get to keep their patients that would not benefit from endovascular. We’re not wasting resources and families don’t need to travel.”