An App to Help Rural Paramedics Improve Timeliness to Deliver Life-Saving Care for Patients Experiencing Heart Attacks

Rural patients lack access to standards of care for serious heart attacks

Timing is essential to begin treatment for ST-elevation myocardial infarction (STEMI), a heart attack with a completely blocked or nearly completely blocked coronary artery. While these heart attacks are a life-threatening cardiovascular emergency, poor outcomes can be mitigated if patients receive treatment within 90 minutes of the cardiac event.

STEMI care is complex with multiple steps, and because of this, it is often not initiated until a patient arrives at the emergency department (ED). In rural areas, emergency medical services (EMS) paramedics must travel long distances to get to patients and then get patients to hospitals. As a result, many patients do not receive this life-saving treatment within the 90-minute window.

“In the Piedmont region of North Carolina, only 60% of rural STEMI encounters meet the 90-minute window for initiating such care. This app has the potential to bring consistent and evidence-based STEMI care to rural areas.” – Dr. John Manning

An evidence-based decision support app will assist EMS teams

To address this issue, researchers from Wake Forest University, led by Drs. Jason Stopyra and John Manning, are developing a clinical decision support mobile app to help rural EMS providers with decision making and initiate STEMI care during transportation, in hopes that its use will improve patient outcomes.

The team will develop the Rural STEMI App, using an open-source, cross-platform mobile application. The app will incorporate guideline-driven and patient-specific treatment assistance for EMS teams addressing patients with STEMI in real time. Additionally, it will include specific, real-time data, including EMS arrival on scene, electrocardiogram time, and Google map integrations of nearby EDs and catheterization labs to support EMS teams and decrease the time to treatment.

App aims to improve care for patients in rural areas

Once the Rural STEMI App is developed and tested for usability, the researchers will test the feasibility and effectiveness of the app in seven rural EMS agencies to determine if the app improves STEMI outcomes, specifically time to treatment. If successful, this will be the first smart-device app to provide real-time, evidence-based, guideline-driven, and patient-specific treatment assistance for EMS teams addressing patients with STEMI.