Abstract 2010: Integration of “Smartphone” Technology in the VA Healthcare System Provides for Accurate and Rapid Near Real Time Interpretation of Electrocardiographic Data in Patients with Acute Myocardial Infarction
Rapid physician viewing of EKG data in patients presenting with suspected acute myocardial infarction is a key step in the delivery of early interventional based reperfusion therapies. Difficulties with this step are a major barrier to achieving the recommended “door to balloon” time of 90 minutes. We hypothesized that existing “smartphone” technology could be integrated to facilitate immediate, near real time viewing of EKG’s in patients presenting with suspected AMI in the VA Healthcare System. Using the existing Veterans Affairs electronic medical record (i.e., CPRS-VISTA) interface we devised an automated system that allowed all EKG’s done in the Emergency Department (ED) to be immediately available for viewing by a remote cardiologist on a standard, commercially available Blackberry Device (AT&T; 8800 series). EKG’s were performed in the ED on a Marquette machine and wirelessly transmitted from the to a centralized MUSE server. The server was configured to automatically forward all EKG’s in a PDF format to 1 or more Blackberry Devices. A validation set of 35 EKG’s were transmitted, viewed remotely and interpreted directly on the Blackberry Device independently by two cardiologist. These readings were then compared to the final traditional reading done from the paper, hard copy of the EKG.
Results: Automatic transmission of EKG tracings was successfull in all cases with 100% of tracings downloadable and available for reading in ≥1 minute. The quality of the tracings with respect to resolution and manipulatability (i.e., zoom, pan, rotate) when viewed on the Blackberry Device was rated adequate for interpretation in >95% of the cases by both readers. Both the presence (11 of 35 cases) and the absence (24 of 35 cases) of acute STEMI was interpreted correctly in 100% of cases with complete concordance between the two interpreting cardiologist. Use of the commercially available Blackberry Device provides a mechanism for remote, rapid, accurate, near real time interpretation of EKG data for the diagnosis of acute myocardial infarction. Integration into existing healtcare systems such as the VA may facilitate achieving target