I grew up watching the Star Trek television series and was always intrigued by the amazing technology that included phasers, warp speed, cloaking devices and the transporter – the fastest (and coolest) way of getting from point A to point B! “Beam me up Scotty” still comes to my mind as the iconic phrase that promises fast and immediate action in the most dire of circumstances.
Today, the San Diego Beacon Community is implementing our own “beaming” technology with dramatic results. We are using health information technology to electronically transmit electrocardiograms (EKGs) from ambulances to hospital emergency departments to ensure faster and better coordinated care for emergency cardiac patients. When a patient demonstrates symptoms of a heart attack, getting the right information quickly to a cardiac specialist is critical.
“Beaming” the EKGs and other relevant health information to the hospital while the patient is still miles away allows for the patient’s condition to be appropriately assessed by specialists before he or she arrives. Then, immediate treatment can be provided as soon as the patient arrives at the hospital. The sooner blood flow is restored to the heart muscle, the better the outcomes for surviving a heart attack.
As one San Diego patient has attested: “My ECG arrived to the ER before I did, and my doctor knew immediately that I was having a heart attack. That information allowed him to make an informed decision about my treatment before he even saw me. Modern medicine is great as far as I’m concerned.”
Of course, not every patient with chest pain is having a heart attack. Unnecessary costs accrue when a cardiac specialist is called to the hospital because of an incorrect heart attack assessment. Having the right health information in the hands of the right people at the right time saves lives and reduces healthcare costs.
The San Diego Beacon Community has made it possible for EKG transmissions to be “beamed” electronically to five emergency departments and cardiac receiving centers in San Diego County. Since these interventions began in January 2011, false positive STEMI incidents decreased from 33.33% to 0% (% = Change from Q1 2011 to Q4 2011). The number of total STEMI incidents decreased from 21 in Q1 to 4 in Q4. While the number of cardiac catheterization lab activations potentially avoided is relatively small, they represent a significant savings with an estimated cost of about $15,000 for each activation.
The Emergency Department is an important gateway between the hospital and its community. With these IT tools, we are linking our hospitals not only with other hospitals and clinics, but with our community partners outside of traditional care settings, such as paramedics and social service providers. As we have shown, these services have a very big impact on improving care and lowering costs.
If you are a patient, it is not too much to ask for “beaming” technology to be implemented in your own community. If you are a physician, technologic advances like these can get you information more quickly when critical decisions must be made. Doing so will improve care, reduce costs, and most importantly save lives. We’re excited about the changes happening in San Diego, and are eager to see more exciting, practical uses of technology take hold across the country.
About San Diego Beacon Community
The San Diego Beacon Community is one of 17 Beacon Communities building and strengthening local health information technology infrastructure and testing innovative approaches to make measurable improvements in health, care and cost. Funded by the Office of the National Coordinator for Health Information Technology, the San Diego Beacon is working to improve the quality of health care delivered for all San Diegans by using health information technology as it pursues five objectives:
- Build a health information exchange (Exchange) that will link health care providers electronically
- Improve care for emergency cardiac patients
- Reduce hospital readmissions
- Reduce unnecessary radiology tests
- Improve childhood immunization rates
To learn more about the San Diego Beacon Community, visit www.SanDiegoBeacon.org and watch here.
Dr. Ted Chan is an emergency medicine physician and the San Diego Beacon Community program leader.
Great post! The hospital that I’m currently working at actually has the same process for patients coming to the ED by ambulance with chest pain. In addition, when a code stemi is called in house the nurse will take a picture with the hospitals iPod and text it to the on call cardiologist for interpretation.
While I appreciate the value of the technologies discussed in this post, I’m not quite sure what is particularly novel about any of these ideas. Should we use telemedicine techniques to help transmit information to expedite and streamline care? Would it help outcomes if all providers could talk to each other (by HIE or whatever other means) to avoid redundant testing and medical issues that may lead to readmissions/etc?
Well, of course. The issue has never been in the value of taking these measures. The issue has always been in how to actually make it happen. There are many initiatives going on around the country. Some of the larger organizations are making a huge push to incorporate tele-health of various measures, including getting patients emailing physicians and having them involved in their own electronic patient record, taking pictures of patients at remote locations and having the photos sent to their physician for an ‘e-appointment’ with video conference, using tele-ICU, etc. Tele-radiology is considered so basic at this point that no one even comments on it as something unique.
AMR and other ambulance companies should absolutely be included in this process, as shown by the example of transmitting an EKG prior to presenting in the ED. The fact that this is considered something novel and innovative, however, really shows the state of our healthcare.
I’m glad this is being done.
Really I am.
Congrats on a nice post.
But to be perfectly honest my reaction is a slack jawed – seriously – we’re not already doing this????? What the ….!!!
Why not? Who the?
You’re kidding me???
Lets get the simple stuff right before we start trying to convince great aunt Mildred to seamlessly post her personal health records to the cloud.