Update on Brainomix

Oxford AHSN’s two-year evaluation of e-Stroke at 26 NHS acute stroke sites shows a higher proportion of patients in the Oxford AHSN region received MT for emergency stroke treatment ( increasing from 2.8% in 2020/21 to 6.6% in 2021/22, with rates more than 1.5 times the national average.)

Treatment with MT is potentially transformative for the 10% of acute stroke admissions who could benefit. Nationally, only one in five eligible patients currently receive this time-sensitive treatment. Increasing this figure is a priority highlighted in the NHS Long-Term Plan. One of the barriers is lack of neuroradiology imaging expertise at smaller stroke units where most patients are initially assessed and require transfer to a comprehensive stroke centre able to deliver MT. This leads to delays in diagnosis and referral.

Delivering a robust MT service is dependent upon rapid identification of LVOs and quantification of the extent of ischaemic injury. This means patients can be referred to a specialist centre within the critical time window to receive the treatment.

The e-Stroke platform is a CE-marked collection of tools that use state-of-the-art AI algorithms to support doctors providing real-time interpretation of brain scans. The software is developed by Brainomix, an OAHP spin-out company, that guides treatment and transfer decisions for stroke patients, allowing more patients to get the right treatment when they need it. The software can uniquely generate critical information from simple brain scans that can help expand patient access to life-saving stroke treatments, like MT, by advancing the clinical value of routine imaging.

●       Please provide details of the change which resulted from the AHSC’s initiatives (e.g., economic impact, net health benefits, increased sustainability of the health and care system, strengthened innovation pipeline etc.).

●       Outline briefly how your AHSC’s initiatives have led to the change described, adding any (qualitative or quantitative) evidence you have to show these activities have led to change, and the unique value, and role, the AHSC designation played in facilitating the change.

Across the South East, OAHP partner, Oxford AHSN, has led a two-year evaluation across the five Integrated Stroke Delivery Networks. It has supported the rollout and evaluation of brain imaging incorporating the e-Stroke suite at 26 acute stroke sites. The evaluation has shown that the improved pathway leads to rapid access to treatment, prevention of long-term disability and improved patient outcomes.

In support of the NHS Long Term Plan priority to improve outcomes for stroke patients, e-Stroke implementation has led to faster access to MT. High-quality CT brain scans are shared quickly and securely between clinical teams, supporting decision making and helping to overcome lasting disruption caused by the Covid-19 pandemic.

In the Oxford OAHP region alone, the proportion of patients receiving MT increased from 2.8% in 2020/21 to 6.6% in 2021/22. These rates are 1.5 times higher than the national average.

Please provide details on who has benefited/been affected (e.g., individuals, specific user/affected groups) from the change, and how, and to what extent (e.g., local, regional, and/or nationally).

–        83% reported faster decision-making and access to MT in patients who need the emergency treatment to improve their outcomes.

–        81% reported improved communication with other clinical sites, showing e-Stroke supports better-connected infrastructure.

–        78% reported that e-Stroke helped to identify more eligible patients for MT.

–        69% reported faster decisions to treat patients.

The national goal for the proportion of patients receiving MT is 10%. Implementing e-Stroke in the OAHP region has seen this increase from 2.8% to 6.6% in 2021/22.

The studies also showed MT can triple the number of people achieving functional independence after having a stroke, from 16% to 48%, by allow allowing more patients to get the right treatment, in the right place, at the right time.

Nationally, e-Stroke is being adopted and spread across three further Integrated Stroke Delivery Networks in England. It has been introduced into 78 NHS hospitals.

The Oxford AHSN evaluation of the impact of e-Stroke on the stroke pathway will support the e-Stroke software to be adopted even more widely across the NHS, enabling more clinicians to deliver MT treatment to more patients when they need it.

Initially introduced at the Royal Berkshire Hospital, Reading, e-Stroke was extended to all five Integrated Stroke Delivery Networks in the South East (Aylesbury, High Wycombe, Milton Keynes, Northampton and Swindon). In 2020, it was introduced in Oxford, making the OAHP Thames Valley region the country’s first AI-enabled regional stroke network, and in 2022, provision of emergency MT services also benefitted from the new capabilities of OAHPs’ integrated acute research and clinical care facility, AMIIC.

AMIIC was established by the close collaboration between three OAHP partners, Oxford University Hospitals NHS Foundation Trust, the University of Oxford, and Oxford Health NHS Foundation Trust. The centre supports both clinical research and clinical services in areas including interventional  cardiology, neuroradiology, neurosurgery, with fully integrated state-of-art photon-counting computed tomography (CT) imaging.

To establish the impact of Brainomix’s digital service, OAHP partner, Oxford AHSN, have led a two-year evaluation of e-Stroke across the five Integrated Stroke Delivery Networks.

Oxford Academic Health Partners and the Oxford AHSN will continue support the implementation of these innovative products across the region.