A Mobile Application for STEMI Care Optimization in a Multicenter Health System
Authors' conclusion
In this observational multicenter implementation study, App-managed STEMI activations were associated with shorter transfer-related time metrics and higher attainment of guideline-relevant time thresholds across 2 interfacility pathways.
Study context
- Population
- STEMI activations in a multicenter health care system, across 2 interfacility transfer routes and 1 percutaneous coronary intervention-capable local pathway
- Exposure
- STEMI activations managed through the App vs the traditional workflow
- Outcome
- Composite:
- Door-to-device (D2D)
- Combined transfer pathway door-in-door-out (DIDO) times
Methodological detailsmulticenter implementation study
- Multicenter implementation study
Main finding
As reported in the abstract
Hodges-Lehmann reduction
16 min
95% CI 8–24P < 0.001
composite door-to-device (D2D); reduction with App
Hodges-Lehmann reduction
12 min
95% CI 6–19P < 0.001
combined transfer pathway door-in-door-out (DIDO); reduction with App
Traditional workflow
- Composite D2D
- 92 min (IQR: 63-110)
- Combined transfer pathway DIDO
- 57.5 min (IQR: 48.3-70.8)
App
- Composite D2D
- 71 min (IQR: 60-85)
- Combined transfer pathway DIDO
- 46.0 min (IQR: 39.5-57.5)
Composite D2D
Combined transfer pathway DIDO
Observational data: associations, not effects.
Further findings
D2D target attainment according to pathway-specific registry benchmarks
P < 0.001
Proportion of transfer cases achieving DIDO ≤45 min
P = 0.006
D2D and DIDO by pathway
- D2D and DIDO improved in both interhospital transfer pathways
- Local pathway showed no significant improvement
Original publication
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