Bernd Montag: Stroke is a Race Against Time for Connected Health Systems

Bernd Montag, Chief Executive Officer at Siemens Healthineers, shared a post on LinkedIn:

“Someone, somewhere, is experiencing a stroke at this moment.

What happens next will depend on speed. It will also depend on something bigger: whether the health system around that person is ready.

For the millions of people who experience a stroke each year, minutes can decide the difference between survival, recovery, and lasting hardships. While the biology of stroke is universal, outcomes still vary widely depending on the patient’s zip code.

That is why the most important question goes broader than infrastructure, expertise, and how quickly the right teams can act.

It is this:

What would a truly stroke-ready health system look like, and how do we build it before the patient arrives?

Closing the hidden time gap

Stroke remains one of the leading causes of death and long-term disability worldwide. How quickly the damage unfolds makes it especially challenging – nearly two million brain cells are lost every minute a stroke goes untreated.

It’s true when we say ‘time is brain’ in stroke care. Like a heart attack, stroke is a medical emergency where every minute matters, but the urgency plays out differently. Damage to the brain can progress silently, and effective treatment depends not only on speed, but on rapidly understanding what type of stroke is occurring and whether brain tissue can still be saved.

In real clinical practice, the challenge is to simultaneously move faster and reduce friction across the entire pathway. Precious minutes can be lost at multiple points: when symptoms are recognized, when emergency teams are activated, when the patient is routed, when imaging is performed, when specialists are engaged, and during the handoffs between teams.

That is why time in stroke is not just about acting fast. It is about connecting fast diagnosis and treatment without delay – so that decisions and action can follow in step, without losing time along the way.

Shifting the starting point of care

Mobile stroke units (MSUs) show what this can look like in practice by shifting the starting point of care. Mobile stroke units can bring CT imaging, lab testing, telemedicine, and stroke expertise directly to where the patient needs it, with the potential of reducing treatment times by around 30 minutes.

We are seeing this approach take shape across different healthcare systems:

• In the U.S., UCLA Health’s mobile stroke unit program has shown how care can begin in the field, with imaging initiated within minutes and treatment delivered 30-40 minutes faster than conventional workflows.
• In Thailand, the MSU-8 at the Siriraj Stroke Center in Bangkok brings hospital-grade imaging into the field that could serve as a prototype for developing MSUs for other hospitals across the region.
• In Germany, the RettungsNetz-5G (Rescue Network 5G) initiative is connecting emergency teams, imaging, and specialists in real time, accelerating decisions from the first contact onward.

Seeing what matters

Speed alone is not enough. It must be combined with precision, and this is where advanced imaging and AI can play central roles.

It starts with bringing imaging closer to the patient. Portable head CT scanners, like those used in mobile stroke units or critical care settings, allow for high-quality brain imaging directly at the point of care.

Instead of moving patients through complex hospital pathways, clinicians can make faster decisions where treatment begins, cutting down on transport time, imaging delays, and gaps in the handoffs.

Early imaging is only the first step. The second is understanding the extent of damage – and whether intervention can still make a difference. This is where advanced techniques such as CT and MR perfusion come in.

Put simply, perfusion imaging shows how blood flows through the brain, helping distinguish between tissue that is already irreversibly damaged and tissue that can still be saved.

Healthcare AI is emerging as a way to enhance this evaluation – helping analyze images more quickly, precisely, and consistently, and supporting decision-making under time pressure.

This insight is what has helped reshape clinical decision-making: in most strokes, a blood clot blocks an artery supplying the brain with oxygen and nutrients. The goal of treatment is to reopen that vessel as quickly as possible – either through thrombolysis (using medication to dissolve the clot) or mechanical thrombectomy (a minimally invasive procedure used to remove it).

Based on strong evidence, updated guidelines now extend treatment windows for these interventions, allowing more patients to benefit from therapy when the right kind of imaging is available at the right time.

Turning handoffs into flow

Stroke care rarely happens in one place. It moves across emergency response, imaging, neurology, interventional teams, intensive care, and rehabilitation. Each step depends on the one before it, and while a faster scan or treatment decision can help, the system around it – and the multiple people comprising that system – must hold it together in real time.

Patient data and diagnostic images can be shared before the patient arrives. Emergency teams, neurologists, and interventionalists can see the same information at the same time, even when they are in different locations.

Decisions can begin earlier.

Preparation can happen sooner.

The handoff becomes less of a delay and more of a coordinated relay.

AI can add another layer by supporting clinical teams and the system around them. It can help prioritize cases as they come in, anticipate demand, and point to where capacity may become constrained. It can highlight where time is being lost between handoffs and support teams in coordinating more effectively.

In doing so, it helps turn a sequence of steps into a more continuous flow.

AI can still play its role at the clinical level by helping read images faster, flag what may need attention, and support decisions when time is limited. Perhaps in the future, AI can help identify why a stroke happened and what needs to change to prevent another one.

But its broader role lies in helping the system function more predictably so that care teams can keep pace with the urgency of the condition, even when demand exceeds the capacity of healthcare professionals available onsite.

In those moments, clinicians no longer need to move physically to the patient (or the patient to the expert). Instead, AI can help extend that expertise, allowing care to reach the patient when and where it is needed.

Taken together, this starts to look less like a series of isolated actions and more like a health system that works as one. A system where cooperation and dovetailing of many players in healthcare can make holistic stroke care possible by leveraging expertise and technology in a way that is consistent, reliable, and most of all, timely.

When the system comes together

One stellar example of this in practice is with our partners at Stroke International Services (SIS) in Vietnam. In 2019, they built a dedicated stroke center, Can Tho Stroke International Services General Hospital, with the intent to bring advanced stroke treatment closer to a region where patients often had to travel hundreds of kilometers for emergency care.

The hospital was built specifically around rapid diagnosis and intervention workflows and over time, has been equipped with advanced CT and MR imaging, hybrid operating rooms, and thrombectomy/interventional capability.

Their model of care also took into consideration how patients reach the hospital. The surrounding Mekong Delta has thousands of rivers, canals, and waterways, sometimes making travel by water faster than on land.

So they launched a system of ambulance speedboats as part of their emergency network that can rapidly reach patients and transport them from river communities to the hospital or transfer points.

Today, SIS has enabled faster access to diagnosis and treatment to more than 17 million patients, and in five years, significantly increased the proportion of stroke patients treated within the critical ‘golden hour’ (i.e. the first 60 minutes after the onset of stroke symptoms) from 13 percent to 22 percent.

A race against time – and a test of system design

Team Healthineers is humbled to be a part of SIS’s journey and to see firsthand how their institution has become a global mecca for stroke treatment that’s not only modern, but, more importantly, really helping an entire population.

A similar approach underpins our partnership with Vall d’Hebron University Hospital in Barcelona, Spain. There, the focus has been on working closely with clinical teams to shape solutions around how care is actually delivered along established workflows and patient pathways.

By combining clinical expertise with data-driven insights, we’ve supported a process of continuous improvement in stroke care. The result has been an overall 40-minute reduction for the entire stroke pathway, helping accelerate access to treatment and improve outcomes for patients.

These, ultimately, are the kind of stroke-ready systems we aspire to scale around the world. Not defined by a single innovation or capability, but how well each part connects so that diagnosis, decision-making, and treatment come together without delay. When that happens, the human impact goes beyond minutes saved. It could mean fewer lives altered by the lasting consequences that stroke can so often leave behind.

That is the future we need to build.”

Proceed to the video attached to the post.

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