Thursday, July 14, 2011

Early Findings Following AirStrip Cardiology Deployment at Three Hospital Systems

We know that communication technologies that transmit ECGs directly to a smart phone or mobile device allow rapid viewing of ECGs by experts and can be used to overcome logistical and geographic barriers to care. This approach has been proven to reduce E2B times, reduce mortality, reduce morbidity, reduce cardiac damage following STEMI, and improve clinical outcomes. [1] [2]

We hypothesized that by improving logistics, visual clarity, touch screen manipulation, and more data for analysis, providers may be able to more quickly and accurately interpret ECG findings. We delivered this with AirStrip Cardiology™ and we added simultaneous and comparative access to historical ECGs from hospital ECG management systems and from EMS in the field. We demonstrated this technology in previous blog entries. [3]

Over the past several months, we have successfully deployed this technology at a number of hospitals. At least 50 clinicians, most of them cardiologists, are presently using AirStrip Cardiology in a dozen facilities at three major health systems across the country – and that number is expected to quadruple by mid-July 2011.

The preliminary results show a great deal of promise. Physicians currently using AirStrip Cardiology have already reported that the clear, concise resolution and touch-enabled analytics significantly improved their ability to diagnose specific conditions, fostered more timely decisions, supported more rapid intervention, and afforded them an experience of freedom and workflow efficiency. This feedback is consistent across all users. We will publish our physician surveys in whitepapers and highlight them in future blogs.

We are learning that great things can happen with mobile, digital, enhanced ECG. For example, AirStrip Cardiology hospital clients have reported improved STEMI patient care, including reduced time to intervention and reduced false activation of the cath lab. Preliminary findings by hospitals include:
  • A median time of 9 minutes from ECG acquisition to view time by a cardiologist, with a resultant 7 - 15 minute reduction in time to intervention.
  • A reduced length of stay of 0.85 days per STEMI case, attributed to earlier intervention. Each STEMI day saved is estimated at $2,500.
  • A 4% -5% reduction in false activation of the cardiac cath lab. The savings per false activation prevented is estimated at $7,500.

How? Physicians and program directors are attributing these benefits to the following features:
  • Immediate, anytime, anywhere access to ECGs, creating the “un-tethered” cardiologist
  • Twentyfold improvement in visual display over paper tracings and pdfs;
  • Automated interval & axis deviation measurement and more digital data; 
  • Elongated strips, making pattern variability more apparent;
  • Access to historical tracings, allowing serial presentation and comparison

We will continue to share lessons learned from the deployment of this mobility solution. We are offering a complimentary webinar series detailing customer results from the use of this technology. We’ll post a link to the registration page in our next blog.

[1]  Sanchez-Ross M, Oghlakian G, Maher J, Patel B, Mazza V, Hom D, Dhruva V, Langley D, Palmaro J, Ahmed S, Kaluski E, Klapholz M. The STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) trial improves outcomes. JACC Cardiovasc Interv. 2011 Feb;4(2):222-7. Patients had significantly shorter D2B times (63 minutes versus 119); lower peak troponin I (39.5 ng/ml vs. 87.6); creatine phosphokinase-MB (126.1  ng/ml vs. 290.3); higher left ventricular ejection fractions (50% vs. 35%); and shorter LOS (3  days vs. 5.5 days).

[2]  Khot UN, Johnson ML, Ramsey C, Khot MB, Todd R, Shaikh SR, Berg WJ. Emergency department physician activation of the catheterization laboratory and immediate transfer to an immediately available catheterization laboratory reduce door-to-balloon time in ST-elevation myocardial infarction. Circulation. 2007 Jul 3;116(1):67-76. Epub 2007 Jun 11.


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