Stroke Golden Hour: Accelerated Care Pathway is a digitally enabled solution implemented by Emirates Health Services (EHS) to enhance stroke care efficiency and reduce door-to-needle time for ischemic stroke patients. Integrated within the EHR "Wareed", this automated clinical workflow streamlines triage, diagnosis, and treatment initiation within the critical first 60 minutes of stroke onset, significantly improving patient outcomes.

The system features intelligent stroke code activation, automated order sets, a thrombolysis eligibility checklist, and real-time clinical decision support.
Key outcomes include a 118-minute reduction in door-to-diagnosis time bringing it to average 52 minutes, lower stroke mortality (from 7.9% to 3.1%), and higher adherence to standardized stroke protocols.

This initiative leverages digitally driven automation and evidence-based medicine to ensure faster triage, quicker imaging, and timely thrombolysis, ultimately saving lives and reducing long-term disability. The project serves as a model for global healthcare systems striving for digitally enhanced emergency stroke care.

https://www.ehs.gov.ae/en/home

• Dubai, Sharjah, Ajman, Fujairah, Ras Al Khaimah, Umm Al Quwain, United Arab Emirates

The Stroke Golden Hour Care Pathway is a highly replicable solution that can be adopted by healthcare systems worldwide to enhance stroke management and reduce treatment delays.
The solution is scalable, adaptable, and designed to be seamlessly integrated into any Electronic Health Record (EHR) system using EHR-based Smart Rules and Clinical Decision Support (CDS).
Key Factors Enabling Replicability:
Standardized Digital Workflow:
The care pathway follows globally accepted stroke management protocols (e.g., BEFAST assessment, NIH Stroke Scale, thrombolysis checklists).
Any hospital using an EHR system with Smart Rules functionality can configure a similar automated workflow.
EHR-Driven Automation & Decision Support:
Smart Rules enable automatic triggering of stroke codes, test orders, and treatment workflows.
The auto-ordering of investigations (CT, MRI, ECG) ensures compliance with stroke treatment timelines.
Training & Implementation Feasibility:
The structured training approach, including video-based modules, allows for rapid adoption in different healthcare settings.
The modular design supports stepwise implementation, even in hospitals with varying levels of digital maturity.
Proven Impact & Evidence-Based Approach:
The program has demonstrated a 118-minute reduction in door-to-diagnosis time, serving as a model for replication.
Compliance with international stroke treatment guidelines makes it adaptable to various healthcare systems.
By leveraging EHR-based automation and Smart Rules, this model can be efficiently replicated in hospitals globally, ultimately saving lives and improving stroke care efficiency.

The Stroke Golden Hour Care Pathway is designed for long-term sustainability by leveraging existing Electronic Health Record (EHR) infrastructure, automation through Smart Rules, and evidence-based clinical workflows.
The following key factors ensure its continued success and scalability:

1. Integration with Existing Digital Infrastructure
The solution is built within the hospital’s EHR system, utilizing Smart Rules and Clinical Decision Support (CDS) without requiring additional software or external AI systems.
As it operates within the existing hospital network, there is no recurring cost for third-party integrations, making it cost-effective.
2. Minimal Maintenance & Operational Costs
The automation is rules-based and does not require frequent updates or manual intervention, reducing the need for continuous IT support.
The workflow is configurable and can be updated as clinical guidelines evolve, ensuring long-term clinical relevance.
3. Workforce Training & Adoption
Training is conducted via e-learning platforms and video modules, allowing scalability with minimal recurring costs.
Healthcare professionals can self-train at their convenience, ensuring continuous education without disrupting clinical duties.
4. Measurable Impact & Continuous Improvement
The system includes built-in performance indicators, enabling hospitals to monitor outcomes and optimize stroke care.
Data analytics support evidence-based refinements, ensuring the system evolves with emerging best practices.
By leveraging existing EHR infrastructure, automation, and data-driven performance monitoring, this initiative is self-sustaining, scalable, and adaptable, ensuring long-term impact on stroke care efficiency and patient outcomes.

The Stroke Golden Hour Care Pathway aligns with the World Summit on the Information Society (WSIS) values by leveraging digital health solutions to improve healthcare accessibility, efficiency, and outcomes. This project contributes to WSIS goals in the following ways: 1. Enhancing Healthcare Through Digital Innovation (WSIS Action Line C7 – eHealth) By integrating Smart Rules and Clinical Decision Support (CDS) within the EHR, the project ensures timely and standardized stroke management, reducing treatment delays. This digital transformation in emergency care helps save lives and prevents long-term disabilities, improving health equity and patient safety. 2. Bridging the Digital Divide in Healthcare The project ensures that all stroke patients receive standardized, high-quality care, regardless of which hospital they visit within the network. It promotes health system efficiency by enabling real-time monitoring, automated alerts, and performance tracking, ensuring equitable access to life-saving treatments. 3. Data-Driven Decision-Making for Sustainable Development The system collects real-time clinical data, allowing healthcare providers to analyze trends, optimize workflows, and improve patient outcomes. This evidence-based approach aligns with WSIS objectives of utilizing ICTs for sustainable development and better governance. 4. Capacity Building & Digital Literacy The project includes e-learning and training resources for healthcare professionals, promoting continuous education and digital literacy. By integrating technology with clinical practice, it empowers medical staff to adopt digital solutions, enhancing overall healthcare delivery. By leveraging digital health technologies, this project exemplifies WSIS values by enhancing healthcare accessibility, reducing disparities, and promoting sustainable, ICT-driven solutions for community well-being.