JMIR Publications

ABSTRACT

Background:

False activation (FA) of cardiac catheterization laboratory (CCL) for ST-segment elevation myocardial infarction (STEMI) is common, adversely affects health care professionals, and results in a financial burden to healthcare systems.

Objective:

The current study assessed if FA minimization can be achieved through implementing a dedicated cloud-based care coordination platform.

Methods:

In September 2021, the McGill University Health Centre (MUHC) implemented a mobile cloud-based STEMI care coordination platform (Stenoa), which allows for systematic case validation with electrocardiogram (ECG) data, followed by prompt case disposition. A retrospective cohort study was conducted on all CCL activations at the MUHC between September 2020 and December 2022. Patients were divided into two groups for analysis: before Stenoa use (Group 0, Sept. 2020 - Sept. 2021) and immediately following Stenoa use (Group 1, Sept. 2021 - Dec. 2022). FA was defined as the activation of the CCL team followed by case cancellation before any procedure was performed. FA rates and the proportion resulting in unnecessary team mobilization (UTM) were compared between groups. The primary outcome of this study was the overall rate of UTM. Data were obtained from the hospital medical records and Stenoa platform data.

Results:

632 patients were included in this study, with 288 patients in Group 0 and 344 in Group 1. The overall rate of UTM was 8.0% (n=23) in Group 0 compared to 4.1% (n=14) in Group 1 (p=0.04). 27 FAs (9.4%) were reported in Group 0 in comparison to 22 (6.4%) in Group 1 (p=0.16). In Group 0, 23 of 27 (85.2%) FAs resulted in UTM, compared to 14 of 22 FAs (63.6%) in Group 1 (p=0.08).

Conclusions:

Use of a cloud-based care coordination platform was associated with a significant reduction in unnecessary CCL team mobilization. This suggests that a dedicated platform may be an effective strategy for optimizing care coordination and resource utilization for STEMI patients.