中風患者應該在短時間內送往具處理中風患者之合格醫院。中風患者治療的 時間拖的越長，越可能會導致患者術後的不良結果。對於鄉村地區的中風患者 來說，情況可能會更加惡化，原因包含缺乏適合的醫療設備、未受過培訓的專 業人員以及到達合格醫院的行車距離相對較長等。在這次的研究中，我們旨在 通過引入遠距中風醫療網絡到臺灣鄉村地區的中風醫療系統中來設法解決上述 說到的問題。提供將患者送往適當醫院最佳路徑的同時，也希望改善偏遠地區 的醫療品質。我們的目標地區是臺灣屏東縣，一共有13家合格醫院作為遠距中 風醫療網絡的成員將會被分為不同的醫療網絡中。我們將使用三種不同的合成 資料來評估所中風醫療網路的性能，並將其與其他情境比較與分析。在延伸分 析中，我們將重新設計的中風醫療網路，進一步分析將目標地區的醫院升級為 能夠進行血管內血栓移除術(Endovascular thrombectomy, EVT)的醫院的影響。 基於結果顯示，我們所提出的中風醫療網絡框架的表現優於其他模擬情境。對 於在中風醫療網絡框架中的患者來說，平均消耗時間(Time Duration, TD) 是最 低的。被送往具有血管內血栓移除術能力的醫院的患者的平均數量也低於一樣 在醫療網路系統下並繞道策略的情境。在更進一步的研究探討中，我們將合格 醫院升級為能夠進行血管內血栓移除術的醫院，深擊的成果比將高雄市的血管 內血栓移除術的醫院直接內入醫療網路中還來的好。總結來說，在中風醫療網 路系統中的單一網絡在考慮中風患者的平均時間消耗和超過時間限制的中風患 者數量時表現最好。此外，將具有血管內血栓移除術的醫院納入系統中將對系 統的性能產生明顯的改善。

Stroke patients should be sent to eligible hospitals in a short time. The longer the patients wait, the more likely it will result in unpleasant outcomes. Situations might get worse for stroke patients in the rural area. In this study, we aim to resolve these obstacles by introducing tele-stroke networks into the stroke medical system in the rural area of Taiwan. Providing the best possible way of sending patients to the proper hospitals and hope to improve the medical quality in the remote area. We will construct the tele-stoke networks in the rural area of Taiwan based on the location of the hospitals and the level of medical emergency. Synthetic data will be used to evaluate the performance of the network system and will be compared to the other scenarios. For the extension of the study, we will reconstruct the pre-design network layouts and further investigate the impact of upgrading the hospitals in the target region into EVT-capable hospitals. The based results have shown the proposed framework has outperformed the other scenarios. For those stroke patients in the proposed framework, the average time duration (TD) has the lowest value among the others. The averaged number of patients that are sent to the hospital with the capability of Endovascular treatment (EVT) treatment is also lower than the scenarios with bypass strategy under the network system. In the extension of the study, upgrading eligible hospitals into EVT-capable hospitals into the network system has performed better than the inclusion of the EVTcapable hospital located at the Kaohsiung City.The framework of the tele-stroke networks have shown great performance compared to the other scenarios. The results shown one-network in the system has performed the best when considering the average time consumption of the stroke patients and the number of stroke patients that exceed the time limits. Also, the inclusion of EVT-capable hospitals into the system will impact the system performance.

1. Introduction (p. 1)
2. Literature Review (p. 3)
2.1 Prevalence of Stroke (p.3)
2.2 Treatment for Acute Ischemic Stroke (p. 4)
2.3 Introduction of Tele-stroke (p. 5)
2.3.1 About Telemedicine (p. 5)
2.3.2 Stroke Telemedicine (p. 5)
2.3.3 Tele-stroke Network (p. 6)
2.4 Related Works (p. 7)
3. Methodology (p. 9)
3.1 Study Settings (p. 10)
3.1.1 Target Region (p. 10)
3.1.2 Process and Time Flow Settings (p. 10)
3.2 Data Synthesization (p. 12)
3.3 Network Implementation Framework (p. 14)
3.3.1 Network Setups (p. 14)
3.3.2 Proposed Framework (p. 15)
3.3.3 Extend Analysis (p. 16)
3.4 Simulation Scenarios (p. 17)
3.5 Evaluation Criteria (p. 18)
3.6 Tool Settings (p. 19)
4. Results (p. 20)
4.1 SyntheticQ Data and Network Layouts (p. 20)
4.2 Base Simulation Results (p. 21)
4.3 Extend Simulation Results (p. 24)
4.3.1 EVT Tele-stroke Network (p. 25)
4.3.2 Upgrading Sequence (p. 27)
5. Discussion and Conclusions (p.29)

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