A Smartphone APPlication for the Transmission of ECGs in the Management of Patients Presenting With Suspected Heart Attacks in the Hamilton, Niagara, Haldimand, and Brant Area

NCT ID: NCT05290389

Last Updated: 2023-11-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

260 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-04

Study Completion Date

2023-11-30

Brief Summary

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The delivery of timely and appropriate care is crucial for patients with heart attacks. Blocked arteries need immediate intervention to restore blood flow. However, the intervention to open the artery is only available in large, regional hospitals. There are only 18 such hospitals across Ontario. Patients with heart attacks in smaller hospitals, where the majority of patients present, require transfer for specialized services. The smartphone application being evaluated in this study is meant to help with communication between doctors to arrange transfer of such patients.

The current model for communication is based on fax machines or non-secure text messages. Additionally, these are not easily accessible for most physicians, so decisions to transfer patients may be based on incomplete information. Unnecessary transfer, treatments, and procedures expose patients and healthcare providers to undue risk.

Smartphone technology is well integrated into clinical practice and widely accessible. The proposed solution being tested is secure and leverages the accessibility of smartphones. Emergency physicians can use this to quickly, securely, and accurately transmit information ensuring faster and appropriate decision making for transfers.

Detailed Description

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A multi-centre, mixed methods observational study focused on Emergency Department physicians who care for patients presenting to a regional partner hospital in the Hamilton, Niagara, Haldimand, Brant Local Health Integration Network (Canada) with suspected ST-segment Elevation Myocardial Infarction (STEMI). There are approximately 700 STEMI patients per year transferred and treated in the Hamilton General Hospital Cardiac Catheterization Lab. As this study is expected to run over the course of one year, it is anticipated that aggregate patient level data on approximately 700 STEMI patients in the STEMI database will be reviewed.

The study will use a pre-post design to evaluate the implementation and use of a clinical intervention, the SMART AMI App. The study will use quantitative registry data already being collected via the ongoing SMART-AMI project (e.g., STEMI database), utilization of data collected from the SMART AMI App, and quantitative and qualitative survey data from participating physicians. As the intervention in this study is a change in process to improve communication between Emergency Department physicians and Interventional Cardiologists, the study does not directly involve patients and individual patient consent will not be required. No new patient data will be collected for the purposes of this study.

Descriptive quantitative analysis and thematic qualitative analysis of survey results will be conducted. Descriptive and inferential statistics will be used for quantitative data derived from patient charts/registry and physician surveys. Continuous variables will be described using mean ± standard deviation. An interrupted time series analysis will be used to compare trends on time-based quality of care indicators. Categorical variables, such as false activation, will be described as frequencies and compared using a Fisher exact test or chi-square test.

Funding for this study was provided by the Hamilton Academic Health Sciences Organization (HAHSO) #HAH-21-015.

Conditions

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Myocardial Infarction STEMI

Keywords

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Mixed-methods Promote Efficient Delivery of Health Care Resources Technology Health Care Delivery

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Physicians

All Emergency Medicine physicians and Interventional Cardiologists involved in STEMI care in the Hamilton Niagara Haldimand Brant Local Health area will be eligible for participation in this study.

SMART AMI APPLICATION

Intervention Type OTHER

SMART AMI allows real-time sharing and review of patient history and ECG between Emergency Department physicians and Interventional Cardiologists to allow for immediate decision-making regarding the need for percutaneous coronary intervention.

Participant physicians will use a smartphone application to communicate, transmit the ECG, and activate the STEMI team. This application enables calling and transmission of up to three images of ECGs, which can be reviewed immediately by the Interventional Cardiologist when communicating with the referring physician.

Interventions

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SMART AMI APPLICATION

SMART AMI allows real-time sharing and review of patient history and ECG between Emergency Department physicians and Interventional Cardiologists to allow for immediate decision-making regarding the need for percutaneous coronary intervention.

Participant physicians will use a smartphone application to communicate, transmit the ECG, and activate the STEMI team. This application enables calling and transmission of up to three images of ECGs, which can be reviewed immediately by the Interventional Cardiologist when communicating with the referring physician.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Emergency Medicine physicians at hospitals and urgent care centres located in the Hamilton, Niagara and Brant Local Health area:

* Brantford General Hospital
* Fort Erie Urgent Care Center
* Greater Niagara General Hospital
* Haldimand War Memorial Hospital
* Hamilton General Hospital
* Joseph Brant Hospital
* Juravinski Hospital
* Main Street West UCC
* Norfolk General Hospital
* Port Colborne Urgent Care Center
* St. Catharines General Hospital
* St. Joseph's Hospital
* St. Joseph's Urgent Care Center
* Welland County General Hospital
* West Haldimand General Hospital
* West Lincoln Memorial Hospital
* Willett Urgent Care Centre

Exclusion Criteria

* N/A
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hamilton Health Sciences Corporation

OTHER

Sponsor Role collaborator

Centre for Evidence-Based Implementation

UNKNOWN

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Madhu K Natarajan, MD

Role: PRINCIPAL_INVESTIGATOR

Hamilton Health Sciences Corporation

Mathew Mercuri, PhD

Role: PRINCIPAL_INVESTIGATOR

Hamilton Health Sciences Corporation

Hassan K Mir, MD

Role: PRINCIPAL_INVESTIGATOR

Ottawa Heart Institute Research Corporation

Locations

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Brantford General Hospital

Brantford, Ontario, Canada

Site Status

Joseph Brant Hospital

Burlington, Ontario, Canada

Site Status

Haldimand War Memorial Hospital

Dunnville, Ontario, Canada

Site Status

Fort Erie Urgent Care Center

Fort Erie, Ontario, Canada

Site Status

West Lincoln Memorial Hospital

Grimsby, Ontario, Canada

Site Status

West Haldimand General Hospital

Hagersville, Ontario, Canada

Site Status

St. Joseph's Urgent Care Center

Hamilton, Ontario, Canada

Site Status

Hamilton General Hospital

Hamilton, Ontario, Canada

Site Status

St. Joseph's Hospital

Hamilton, Ontario, Canada

Site Status

Main Street West UCC

Hamilton, Ontario, Canada

Site Status

Juravinski Hospital

Hamilton, Ontario, Canada

Site Status

Greater Niagara General Hospital

Niagara Falls, Ontario, Canada

Site Status

Willett Urgent Care Centre

Paris, Ontario, Canada

Site Status

Port Colborne Urgent Care Center

Port Colborne, Ontario, Canada

Site Status

Norfolk General Hospital

Simcoe, Ontario, Canada

Site Status

St. Catharines General Hospital

St. Catharines, Ontario, Canada

Site Status

Welland County General Hospital

Welland, Ontario, Canada

Site Status

Countries

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Canada

References

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Mir H, Cullen KJ, Mosleh K, Setrak R, Jolly S, Tsang M, Rutledge G, Ibrahim Q, Welsford M, Mercuri M, Schwalm JD, Natarajan MK. Smartphone App for Prehospital ECG Transmission in ST-Elevation Myocardial Infarction Activation: Protocol for a Mixed Methods Study. JMIR Res Protoc. 2024 Sep 6;13:e55506. doi: 10.2196/55506.

Reference Type DERIVED
PMID: 39240681 (View on PubMed)

Other Identifiers

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HAH-21-015

Identifier Type: -

Identifier Source: org_study_id