Six acute stroke patients treated in one month

Why minutes decided it

The medicine had a three‑hour deadline. Assembling the team was what blew it.

Clot‑dissolving treatment only works inside three hours of the first symptom. By 2001 the drug was well understood. What was not solved was reaching a neurologist, a radiologist, a CT technologist, the lab, pharmacy and the stroke nurses — all at once, at three in the morning, and knowing for certain that each of them had actually received the message.

treated in the first month, after

treated in the whole of 2000

disciplines alerted in parallel

hemorrhage complications in those six

All six improved in functional and neurological status. Some were discharged with complete resolution or minimal disability. Recorded in the institute’s own staff memo of 30 November 2001, four weeks after the protocol began.

And the baseline was not cherry‑picked. The local newspaper reported the same year that the hospital had given the drug three times in all of 2000, and three more by the middle of October 2001 — the rate was still unchanged in the weeks before the protocol started. Three separate records agree: the hospital’s press release, the institute’s internal memo, and the newspaper.

This was measured, not asserted

Every week, a test alert went to the entire stroke team. The results were written down.

Not to the physicians on call — to everybody. Each group’s delivery and reply rate was recorded, and every failure was logged with its cause.

Group	On roster	16 Oct 2001		23 Oct 2001
Group	On roster	Delivered	Replied	Delivered	Replied
Neurologists	8	100%	100%	100%	100%
Radiologists	9	67%	67%	78%	78%
Stroke nurses	2	50%	50%	100%	100%
CT technologists	3	66%	0%	100%	100%
Pharmacy	1	100%	100%	100%	100%
Lab	1	100%	100%	100%	100%
MRI, first shift	7	86%	86%	100%	100%
MRI, second shift	3	100%	0%	100%	0%

Every miss has a recorded reason: a pager out of battery, one non‑functional and replaced, two numbers wrongly programmed in a user profile and corrected, and staff on vacation. When pharmacy replied after sixteen minutes instead of three, the memo notes the training given that same day — and the following week pharmacy answered in under three minutes. The one persistent gap, MRI second shift, is explained in the memo too: they were not at work at nine in the morning.

The drill log behind those memos survives — 309 timed deliveries between October 2001 and January 2002, each one a real message to a real pager, timestamped on the way out and on the way back.

82s

median time to confirmed delivery

94%

confirmed inside two minutes

309

timed deliveries on record

disciplines, one activation

Under a minute and a half, on the two‑way pager networks of 2001, to reach an entire seven‑discipline team at once — and to know that it had arrived. The alternative that morning was a switchboard telephoning people one at a time and hoping.

What it actually did in 2001

Read this list and you are reading the product we sell today.

A team composed from many schedules

Neurology, radiology, CT, MRI, lab, pharmacy and nursing each kept their own on‑call schedule. The system assembled them into one team.

One search, one activation

The emergency department operator searched for the stroke team. Only the people actually on call that night were alerted.

Sixteen people, in parallel

Not a phone tree. Every device received the alert simultaneously, with the patient detail already in the message.

Delivery and reply receipts

Confirmation travelled back to the sender. In the words of the protocol, it took the guesswork out and made on‑call staff accountable.

A timestamped audit trail

Every submission, delivery and reply archived for quality control — which is precisely why the measurements above exist.

A cancellation alert

When a patient turned out not to be a candidate, one message stood the whole team back down.

What the clinicians said at the time

The people running the stroke team were on the record in 2001.

Quoted by role rather than by name, in their own words, to the press of the day.

“This technology is providing a means for the Emergency Department to communicate with the right people very quickly.”

A neurologist on the hospital’s stroke team
· hospital press release, 2001

“These tools just save a lot of tracking down time. I’ve heard nothing but positives about it.”

Another of the stroke team’s neurologists
· hospital press release, 2001

Published, not just claimed

The work was written up and presented to the American Stroke Association.

Nine authors across the neuroscience institute, hospital radiology, and radiology at Wright‑Patterson Air Force Base.

Full scientific poster: An Innovative Approach using High Speed Imaging and Wireless Communication in Acute Stroke Care, presented at the American Stroke Association

An Innovative Approach using High Speed Imaging & Wireless Communication in Acute Stroke Care. Robinson, Ruppert, Pugar, Valle, Schoonover, Adineh, German, White and Ezzeddine. Effort sponsored by the Air Force Research Laboratory (AFRL‑HEOX), Air Force Material Command, USAF, under Cooperative Agreement F33615‑98‑2‑6002.

Funded by

U.S. Air Force Research Laboratory
Cooperative Agreement F33615-98-2-6002

Principal investigator

Bilal Ezzeddine, PhD
today Co‑Founder & CTO of MatchMD

Presented at

American Stroke Association
International Stroke Conference, 2002

Measured over

Weekly drills, autumn 2001
every group, every week, logged

Where this stands in 2026

This did not turn into a solved problem. It turned into a bigger one.

The clot-dissolving window has widened, so more patients now qualify — while the target time to treat them has tightened. Assembling the team is still where it is won or lost.

4.5h

standard window today, up from three

60min

door-to-needle target, in 85% of cases

19%

of rural emergency departments hold any stroke certification

7,000

calls a year into one regional stroke team from other hospitals

The window kept opening

Hours from symptom onset in which treatment is still on the table, under the 2026 guideline. The dashed line is where the window sat during our 2001 study.

2026 AHA/ASA Guideline for the Early Management of Patients With Acute Ischemic Stroke.

Arriving in time is not the same as being treated

Of patients who reached hospital inside the window, the share who actually received clot-dissolving treatment.

Get With The Guidelines–Stroke, 2017–2019, published in Stroke, 2024. Patients presenting within 4.5 hours.

The link was installed. The call still was not made.

Three rural critical-access emergency departments, five months. Of the patients who met the criteria for a telestroke consult:

Analysis of Telestroke Usage in Rural Critical Access Emergency Departments, 2023. Of the 14 consulted, 93% proved to be a genuine stroke or transient ischemic attack.

Read those three together. More patients qualify than ever. The hospitals furthest from a stroke centre treat the fewest of them. And where the technology was already installed, more than half of the eligible activations still never happened — because somebody had to decide to make the call, and reach the right person.

Twenty-four years later

The same activation. Now it is a phone in a pocket.

The pagers are gone. Everything else on this page is still how MatchMD works — groups keeping their own schedules, one activation assembling the whole team, messages delivered in parallel, and a receipt for every one of them. Today a single activation still assembles a dozen groups across an entire health system.

How it works today Book a demo

The point of all this

We did not start with an app. We started with a stopwatch.

Everything on this page is from 2001 and 2002, and we publish it with the dates on. It is not a claim about what we are doing this quarter. It is where the measurements came from, and why we have never stopped taking them.

Data collected 2001–2002 · Published as recorded

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