{"stable_id":"b967943b4e81c041","slug":"nhs-brainomix-stroke-transfer","company":"NHS England stroke networks","workflow_name":"Brainomix e-Stroke AI decision support in the thrombectomy pathway","function_code":"customer_service","pattern_codes":["exception_based_operations"],"changed_assumption":"AI can surface suspected stroke-transfer cases before sequential specialist communication finishes.","evidence_strength":"verified","publication_tier":"showcase","freshness":"current","reviewed_at":"2026-08-23","updated_at":"2026-08-22","source_quality_summary":"1 peer reviewed, 1 primary; publication outcomes are verified.","caveat_summary":"Retrospective before/after observational study with small cohorts; other temporal effects cannot be fully excluded.","freshness_caveat":null,"workflow_summary":{"before":[{"actor":"Acute stroke center clinician","action":"Acquire CT imaging and wait for local interpretation and sequential specialist consultation.","actor_type":"human"},{"actor":"Specialist team","action":"Review images and decide whether to accept the patient for thrombectomy.","actor_type":"human"}],"hinge":"AI can surface suspected stroke-transfer cases before sequential specialist communication finishes.","after":[{"actor":"e-Stroke AI","action":"Analyzes CT images and rapidly surfaces features consistent with large-vessel occlusion.","actor_type":"ai"},{"actor":"Clinical teams","action":"Review shared images and AI output in parallel, decide treatment and transfer, and initiate transport.","actor_type":"system"}],"decision_mode":"shared","decision_marker":"AI handles the default; humans own exceptions"},"before":[{"order":1,"actor":"Acute stroke center clinician","action":"Acquire CT imaging and wait for local interpretation and sequential specialist consultation.","handoff_to":"Comprehensive stroke center","control":"Local escalation pathway"},{"order":2,"actor":"Specialist team","action":"Review images and decide whether to accept the patient for thrombectomy.","handoff_to":"Transfer team","control":"Clinical decision"}],"after":[{"order":1,"actor":"e-Stroke AI","action":"Analyzes CT images and rapidly surfaces features consistent with large-vessel occlusion.","handoff_to":"Local and specialist clinicians","control":"Decision-support only"},{"order":2,"actor":"Clinical teams","action":"Review shared images and AI output in parallel, decide treatment and transfer, and initiate transport.","handoff_to":"Thrombectomy center","control":"Clinicians retain diagnosis and treatment rights"}],"decision_rights":"AI supports scan interpretation; clinicians decide diagnosis, referral acceptance, thrombolysis, thrombectomy, and transfer.","exception_path":"Clinicians override or disregard AI output when imaging, symptoms, or eligibility criteria conflict; standard stroke pathways remain available.","removed_work":["Sequential waiting for specialist image interpretation","Manual image-transfer friction before referral discussion"],"outcomes":[{"metric":"Door-in-door-out time at an acute stroke center","baseline":"141 minutes before e-Stroke deployment","result":"79 minutes after deployment, a 62-minute reduction","period":"14 months before versus 12 months after 2020-03-01 deployment","scale":"One U.K. acute stroke center; 47 referred patients across pre/post cohorts","attribution_caveat":"Retrospective before/after observational study with small cohorts; other temporal effects cannot be fully excluded.","evidence_label":"verified"}],"executive_lesson":"The value came from collapsing sequential interpretation and transfer handoffs, not from replacing the stroke specialist.","anti_pattern":"Publishing the tripling in functional independence as causal without carrying the observational design and small sample.","questions_for_leaders":["Which waiting step is removed by the AI output?","How are false-positive transfer recommendations handled?"],"collections":["human-still-decides"],"bundle_version":"1.0.0","bundle_fingerprint":"sha256:c23c6cc2b88153d008ea8fda928f632ce0011fc2d4c5036672a16e5d895bab93","canonical_url":"https://brianletort.ai/transformations/nhs-brainomix-stroke-transfer"}