Smartphone application for transmission of ECG images in pre-hospital STEMI treatment

An S-T segment elevation myocardial infarction (STEMI) is a severe heart attack that kills heart muscle every minute it is left untreated. Therefore, early diagnosis and treatment are crucial for patient survival. Currently, Charlottesville ambulances that service the University of Virginia hospital are equipped with proprietary systems that send electrocardiogram (ECG) images while the ambulance is en route to the hospital. From an ECG, a doctor can diagnose a STEMI prior to patient arrival and prepare for surgery, thereby reducing the time delay. However, these ambulance systems are costly and provide no feedback regarding the success of an ECG transmission. This paper describes the development of an inexpensive iPhone application that transmits ECG images over the AT&T data network to the hospital prior to a patient's arrival. The application is designed to dovetail with the existing STEMI-care protocol used by Charlottesville-area Emergency Medical Technicians (EMTs), and it provides a novel red/green light indicator predicting successful receipt of the image within two minutes. The goal of the application is to improve process efficiency and information flow allowing the patient to receive early, appropriate care and the best chance for a successful recovery. Test results, including usability tests, show that the application fulfills all key requirements. A prototype of the application will be evaluated by Charlottesville area Emergency Medical Technicians prior to implementation in emergency response protocols and long term deployment elsewhere.