Mobile application to optimize care for ST-segment elevation myocardial infarction patients in a large healthcare system, STEMIcathAID: rationale and design

Abstract

Technological advancements have transformed healthcare. System delays in transferring patients with ST- segment elevation myocardial infarction (STEMI) to a primary percutaneous coronary intervention (PCI) center are associated with worse clinical outcomes. Our aim was to design and develop a secure mobile application, STEMIcathAID, streamlining communication and coordination between the STEMI care teams to reduce ischemia time and improve patient outcomes. The app was designed for transfer of patients with STEMI to a cardiac catheterization laboratory (CCL) from an emergency department (ED) of either a PCI capable or a non-PCI capable hospital. When a suspected STEMI arrives to a non-PCI hospital ED, the ED physician uploads the EKG and relevant patient information. An instant notification is simultaneously sent to the on-call CCL attending and transfer center. The attending reviews the information, makes a video call and decides to either accept or reject the transfer. If accepted, on-call CCL team members receive an immediate push notification and begin communicating with the ED team via a HIPPA compliant chat. The app provides live GPS tracking of the ambulance and frequent clinical status updates of the patient. In addition, it allows for screening of STEMI patients in cardiogenic shock. Prior to discharge important data elements have to be entered to close the case. In conclusion, we developed a novel mobile app to optimize care for STEMI patients and facilitate electronic extraction of relevant performance metrics to improve allocation of resources and reduction of costs.

Pretransfer Aspirin Administration and Its Impact on Angiographic Outcomes for Patients with ST-Elevation Myocardial Infarction

“…19) Moreover, it becomes important to establish a comprehensive STEMI care system, incorporating an ECG transmission system to swiftly and accurately diagnose patients with STEMI. 20) The present study demonstrated an independent association between pretransfer aspirin administration and achievement of initial TIMI-3 flow in the IRA, indicating that pretransfer aspirin administration may partially contribute to the beneficial effects of PCI on infarct size in patients with STEMI. Platelet activity can be inhibited within an hour of aspirin administration, which typically reaches peak plasma concentration within 30-40 minutes.…”

Design and deployment of ODISEA, an application for the myOcarDial infarction SafEtytrAnsfer of patients

“…Although, this application does not provide information of patient position or communication channels between members of the team, an special mention has to be done for being the first one to be proposed to support STEMI management. The second application is STEMIcathAID, proposed by Krishnamoorthy et al [11]. This mobile app optimizes care for STEMI patients and facilitates electronic extraction of relevant performance metrics to improve allocation of resources and reduction of costs.…”

“…Park et al [9] evaluated how the use of a smartphone social network system in a regional STEMI network can reduce the ischemic time. Focused on STEMI management, Dickson et al [10] proposed STOP-STEMI an application to improve the coordination of STEMI care and Krishnamoorth [11] proposed an HIPAA compliant app for the transfer of patients with STEMI.…”