Leading the Way in Quality of Care: Wireless Transmission of 12Lead ECG's From Ambulance to ER

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Leading the Way in Quality of CareWireless
Transmission of 12-Lead ECG'sFrom Ambulance to ER

• Physio Control LifeNet Solutions
• Frederick Memorial Healthcare System
• Presented by Tanya Miller
• Senior Systems Analyst
  / Project Manager
• Prepared by Tanya Miller, Information
  Services
• Cindy Russell, Director
  of Nursing Finance
• Dave Chisholm, RN, EMT,
  Battalion Chief

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Objectives
• Why We Installed LifeNet
• Overview of LifeNet Product
• Technology
• Implementation Process
• Results

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• ST-Elevation Myocardial Infarction (STEMI) is a
  dangerous form of heart attack that poses a
  serious threat to the heart muscle.
• The quicker patients receive treatment, the more
  likely they are to have positive outcomes and
  survive the event.
• The goal is to reduce door-to-balloon time,
  saving heart muscle and saving lives.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• The American Heart Association estimates that
  nearly 400,000 people in the U.S. experience
  STEMI every year.
• Studies have reported a significant relationship
  between pre-hospital 12-lead ECGs and shorter
  door-to-balloon times, the effect was strongest
  when the Cath Lab was activated while the patient
  was still in route to the hospital.
• LifeNet is a wireless technology that helps
  improve STEMI care with a web-based solution
  enabling the activation of Cath Lab team in
  advance of the patient arrival.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ERLifeNet
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• LifePak Defibrillator used in the ambulance sends
  an ECG tracing to a gateway, using wireless
  communications.

• The destination site is configured and selected
  on the LifePak device.
• A wireless modem is attached to each LifePak.
• We expanded our existing cellular service plan to
  include transmission of data.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• The Gateway sends the reports from the LifePak
  device to the LifeNet Cardiac Care Server.
• Reports are sent through
• the Internet using standard
• secure Internet protocols.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• The LifeNet Cardiac Care Web Server looks to a
  routing table, which contains information
  pertaining to transmitting devices and the
  intended destinations.
• Routing information stored on the Web server
  includes identifiers for the following
• Transmitting Devices
• Modems
• Receiving Site
• Receiving/Alert Clients
• Print Client
• Notifications

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• LifeNet Receiving Station receives the
  transmission
• The ECG tracing flashes on the screen until
  acknowledged.
• Theres an audible alarm on the PC.
• The tracing is automatically printed on a
  designated network printer.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Alert Client forwards 12-lead reports and
  notification to other destinations.

• Pager
• E-Mail
• Phone

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• This data can be used for diagnosis, disposition,
  and therapy decisions by qualified medical
  personnel, prior to the patients arrival in the
  E.R.

• The Cardiologist reviewing the tracing may choose
  to activate a Code Heart.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• The Code Heart Team is ready to treat the patient
  upon arrival.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• The speed of transmission
• 22 seconds
• 1 minute, 30 seconds
• Job Timeout
• Cellular coverage issues
• If job times out, EMT simply re-sends

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Results
• Average door-to-balloon time for a STEMI patient
  without LifeNet, presenting to the ER and moving
  to the Cath Lab, is 63 minutes.
• In patients where LifeNet is used, weve been
  able to reduce our door-to-balloon time to 49
  minutes.
• Scenario LifeNet Transmission received, Code
  Heart initiated, Team ready per standard
  protocol, patient arrived and was in the Cath Lab
  within 40 minutes.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Implementation
• Local Software Installation
• WebSite Configuration Data Workflow
• Receiving and Alert Devices
• Printer
• Modems
• Users Accounts
• Report Distribution
• Auto Notifications
• Educational Sessions E.R. Staff
• Workflow
• Feature/Functionality

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Hardware Deployment
• Hardware installation in each ambulance.
• Trained EMTs
• Test transmissions from each LifePak.

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER
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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Making a Difference
• I am pleased and happy to report that today our
  Code Heart was called prior to the pt's arrival,
  due to the tracing sent in by the EMS. GREAT JOB
  BY ALL!!!!!! Jackie
• HEY, We had another one Saturday. Called the
  code heart before pt was here!!! Jackie
• Thanks Tanya, nice work on this project. This
  one is saving lives. Cindy

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Quality Care Requires Teamwork

• Responsibility
• Utilize and implement current tools and
  technology

• Goal
• Put the right information, in the right hands, at
  the right time, to make the right decisions

• Result
• Positive Outcomes
• Saving Lives

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Wireless Transmission of 12-Lead ECG'sFrom
Ambulance to ER

• Thank You
• Questions or Comments