Towards a Ubiquitous Healthcare System for Acute Myocardial Infarction Patients in Brazil

Abstract

After an Acute Myocardial Infarction (AMI), the sooner the patient is approached, the greater are the chances that pharmacological therapy (using thrombolytics) be more effective than surgical intervention. Nevertheless, the thrombolytic therapy may have hazard effects on AMI patients that present any contraindication to it. As a consequence, paramedics usually hesitate about applying the thrombolytic therapy-preferring to immediately transfer patients to coronary care units (CCUs)-unless cardiologists support their decision. To cope with this scenario, we envision a ubiquitous telemedicine system for supporting cardiologists and paramedics in (i) the remote decision upon the eligibility of AMI patients to the thrombolytic therapy and (ii) the remote monitoring of patients being transferred. socalled In this paper, we present AToMS (AMI Teleconsultation & Monitoring), a system that makes extensive use of (possibly heterogeneous) wireless communication technology to allow its use by a paramedic at the location where the AMI patient is first assisted, thus reducing the delay between the onset of symptoms and the eventual application of proper treatment. All exchanged messages among paramedics and cardiologists are recorded, thus rendering a fully auditable system.

SPLiCE

“…As future work, we intend to validate the proposed method and the software product line SPLiCE by modeling realworld legacy HISes (e.g., [6]) and comparing the generated HIS skeletons with such systems. This is a research program towards a software product line for healthcare applications which is part of a larger nationwide research network in Brazil dedicated to computer-aided healthcare called INCT-MACC.…”

“…On the one hand, it is our experience with the development of a teleconsultation system for prehospital delivery of thrombolysis for infarction patients [6] that clinical data modeling takes much of the attention of the development team. As the system takes form, there is continuous data modeling changes required by the physician end-user, who is in general beset by articulating his knowledge.…”

Suporte remoto ao atendimento médico emergencial de vítimas de infarto via dispositivos móveis

“…Pesquisas médicas recentes em cardiologia [6] mostram que o tratamento terapêutico com trombolíticos -fármacos que permitem a desobstrução arterial -reduz a mortalidade e facilita a recuperação do paciente, além de ser menos custoso em comparação com procedimentos cirúrgicos. Contudo, para aumentar sua eficácia, esse tratamento deve ocorrer, em geral, entre 30 a 90 minutos após o aparecimento dos primeiros sintomas de IAM [1], e só pode ser ministrado mediante uma análise prévia de elegibilidade do paciente de * Em trabalhos anteriores foram apresentadas uma visão geral do sistema AToMS [4] e algumas considerações sobre o uso de abordagens orientadas a aspectos [5] na especificação arquitetural do mesmo [2]. O objetivo do presente trabalhó e apresentar em detalhes as principais decisões de projeto e o estado atual de implementação desse sistema.…”