Using Mobile Health Solutions to Improve Patient Care and Realize Efficiencies, a case study of LIFENET Systems STEMI Management Solution. Presented at the Johns Hopkins University Carey Business School.
Over 500,000 cases of ST-segment elevation myocardial infarction (STEMI) annually in USWithout Percutaneous Coronary Intervention (PCI) treatment, one-third die within 24 hoursLess than 25 percent of U.S. hospitals have the ability to perform PCI (regionalization) 5600+ STEMIs per year in Maryland
Fewer than 40 percent of patients receive PCI within the 90-minute timeframe recommended by American Heart Association (AHA). (time is a factor)If timeframe stretches from 90 to 120 minutes, mortality increases by 40 percent.
Data communication examples: Vehicle locating and dispatch systems, patient care recording technology and other medical monitoring devices LIFENET Cardiac Care System is a hosted ECG data distribution service that includes:The Physio Control LIFEPAK 12 is a multi-parameter device that combines semi-automated and manual defibrillation and a 12-lead electrocardiography and other monitoring functions.The Cardiac Care System receives ECGs from pre-hospital LIFEPAKs and distributes them to emergency department (ED) physicians in hospitals and cardiologists in treatment centers.
“ECG data collected by the LIFEPAK can be transmitted to the Cardiac Care System, and then distributed to printers, fax machines, or emails to be analyzed by ED physicians and cardiologists.”The In Motion onBoard™ Mobile GatewayThe In Motion Technology onBoard Mobile Gateway is key part of the Physio Control STEMI management solution,bridging the communication between the LIFEPAK 12 and the LIFENET Cardiac Care System. By using direct wiredserial communication, or Bluetooth wireless communication, ECG data collected by the LIFEPAK can be transmittedto the Cardiac Care System, and then distributed to printers, fax machines, or emails to be analyzed by EDphysicians and cardiologists.Requires:Physio Control Requirements Physio Control LIFEPAK 12 Physio Control LIFEPAK 12 Defibrillator-to-PC Serial Port Interface Cable (PN: 3009817-00) Physio Control LIFENET Blue (optional)In Motion Technology Requirements onBoard Mobile Gateway, Release 2.6.2 or higher In Motion Technology Physio Control Application Module
How does integration reduce costs?* Fewer false positive Cath Lab activations (each activation costs labor, materials)How does integration improve outcomes?* Time to baloon reduced (mortality goes down)---Case study: Dallas Fire and Rescue * LIFENET allows paramedics to transmit 12-lead EKGs from the field to a web-based system at the hospital.* Distributes the information via the Internet to care teams at the hospital's ER, catheterization lab and the cardiologist's handheld device.* Rapid delivery of the EKG data allows hospital to prepare for the patient's arrival ahead of time, able to make treatment decisions while the patient is still in transport.* Knowing the diagnosis before the patient arrives can significantly reduce the amount of time it takes to care for the patient upon arrival and improve overall patient outcomes.* Standard guideline for this treatment process is currently 90 minutes. With the new software, Dallas Fire and Rescue hopes to eventually shorten the process to 60 minutes or less.
How does regionalization reduce costs?*Cost of PCI care and Cath Lab activation pooled to specialized centersHow does regionalization improve outcomes?* Specialized centers better prepared for STEMI patients* 5600 plus STEMIs per year in Maryland
STEMI Teams include:PharmacistLab TechRadiologyMedical RNSurgical RNICU RNCardiologisthttp://www.avera.org/pdf/avera/Session%20II%20-%20NEW%20Lifenet%20STEMI%20Network-2009.pdf
Rapid delivery of the EKG data allows hospital to prepare for the patient's arrival ahead of time, able to make treatment decisions while the patient is still in transport.Knowing the diagnosis before the patient arrives can significantly reduce the amount of time it takes to care for the patient upon arrival and improve overall patient outcomes.Standard guideline for this treatment process is currently 90 minutes. With the new software, Dallas Fire and Rescue hopes to eventually shorten the process to 60 minutes or less.
**This time & money frees up additional resources which can be used for conducting research, seeing additional patients, etc. This ultimately makes the process more efficient and can potentially increase profits
Using Mobile Health Solutions to Improve Patient Care and Realize Efficiencies
Using Mobile Health Solutions to Improve Patient Care and Realize Efficiencies<br />Case Study: LIFENET Systems STEMI Management Solution<br />Mark Brown<br />SegunFamuyide<br />Shaun Johnson<br />Cyrus Jovan<br />Erin McCoy<br />Kevin Popp<br />Ted Simpson<br />Anthony Soules<br />Daryl Washington<br />
Problem Statement<br />Fifteen (15) percent of about five million Americans who show up in emergency rooms with chest pain in a year are actually experiencing a heart attack(Source: Dept. of Veterans Affairs, 2001)<br />283K Americans die from heart attacks annually according to a 2010 statistics provided by the American Heart Association<br />
General Problem<br />Can we apply specific mobile health (mHealth) solutions to known health problems to both improve patient care and realize efficiencies as it relates to cardiac patients?<br />
ST-Segment Elevation Myocardial Infarction (STEMI) <br />“Severe heart attack caused by a prolonged period of blocked blood supply that affects a large area of the heart. These attacks carry a substantial risk of death and disability and call for a quick response by many individuals and systems.”<br />American Heart Associationhttp://www.americanheart.org/presenter.jhtml?identifier=3061532#stemi<br />
Time is a critical factor<br />STEMI patients should be transported directly to the closest regional primary PCI-capable hospital and receive treatment within 90 minutes<br />American Heart Association – Circulation 2007http://www.americanheart.org/presenter.jhtml?identifier=3050319<br />
How can a mobile health solution help? <br /><ul><li>Creates a “vehicle area network” to provide connectivity for all on-board data communications
Utilizing the Internet, First Responders can send cardiac information from the field to hospital care teams
Example: LIFENET Systems STEMI Management Solution</li></li></ul><li>How Does It Work?<br />How Does It Work?<br />
Outcomes and Efficiencies?<br />“Integration of pre-hospital and hospital<br />phases of care essential to optimal outcomes”<br />Background and Update on STEMI System Development Maryland Institute for Emergency Medical Services Systems (MIEMSS)http://www.eecreg5.org/Pyramid/2008/Presentations/STEMI_System%20.pdf<br />
Outcomes and Efficiencies?<br />“Regionalization of emergency care<br />reduces costs and improves outcomes”<br />
Stakeholder: Hospital<br /><ul><li>Goals: Reduce Cost, Improve Quality of Care
Regional EMS strategy is both less costly and more effective than all hospital strategies</li></ul>The Comparative Effectiveness of STEMI Regionalization Strategies http://ashecon2010.abstractbook.org/presentations/733/<br />
Stakeholder: Physician<br /><ul><li>Goals: Improve Quality of Care, Make Correct Diagnosis, Save Lives
Improved outcomes and increased efficiency should have longer term impact on cost of healthcare </li></li></ul><li>Cost Benefit Analysis<br />***Centers for Disease Control and Prevention - National Center for Health Statistics<br />
Cost Benefit Analysis<br />***Centers for Disease Control and Prevention - National Center for Health Statistics<br />