Key result
An automated FHIR-based 12-lead ECG mobile alert system successfully transmitted 94% of alerts within 5 minutes for patients with suspected acute coronary syndrome in the emergency department.
Why the study?
For patients with time-critical acute coronary syndrome, reporting ECG findings is vital, motivating the development and validation of an automated FHIR-based 12-lead ECG mobile alert system for emergency departments.
Does an automated FHIR-based 12-lead ECG mobile alert system successfully and rapidly transmit ECG findings for suspected acute coronary syndrome in emergency department patients?
Observational (n=1,581)
No
Does an automated FHIR-based 12-lead ECG mobile alert system successfully and rapidly transmit ECG findings for suspected acute coronary syndrome in emergency department patients?
An automated FHIR-based 12-lead ECG mobile alert system can successfully and rapidly transmit ECG findings to physicians in the emergency department, though diagnostic accuracy requires improvement to prevent missed STEMI cases.
Supports rapid ECG alert feasibility in ED cohort; leaves open diagnostic accuracy and clinical outcomes.
For patients with time-critical acute coronary syndrome, reporting electrocardiogram (ECG) findings is the most important component of the treatment process. We aimed to develop and validate an automated Fast Healthcare Interoperability Resources (FHIR)-based 12-lead ECG mobile alert system for use in an emergency department (ED). Materials and Methods: An automated FHIR-based 12-lead ECG alert system was developed in the ED of an academic tertiary care hospital. The system was aimed at generating an alert for patients with suspected acute coronary syndrome based on interpretation by the legacy device. The alert is transmitted to physicians both via a mobile application and the patient's electronic medical record (EMR). The automated FHIR-based 12-lead ECG alert system processing interval was defined as the time from ED arrival and 12-lead ECG capture to the time when the FHIR-based notification was transmitted. Results: During the study period, 3812 emergency visits and 1581 12-lead ECGs were recorded. The FHIR system generated 155 alerts for 116 patients. The alerted patients were significantly older [mean (standard deviation): 68.1 (12.4) years vs. 59.6 (16.8) years, p<0.001], and the cardiac-related symptom rate was higher (34.5% vs. 19%, p<0.001). Among the 155 alerts, 146 (94%) were transmitted successfully within 5 minutes. The median interval from 12-lead ECG capture to FHIR notification was 2.7 min [interquartile range (IQR) 2.2-3.1 min] for the group with cardiac-related symptoms and 3.0 min (IQR 2.5-3.4 min) for the group with non-cardiac-related symptoms. Conclusion: An automated FHIR-based 12-lead ECG mobile alert system was successfully implemented in an ED.
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Hur et al. (2020) conducted an observational in Suspected Acute Coronary Syndrome (n=1,581). Automated FHIR-based 12-lead ECG mobile alert system was evaluated on Successful transmission of 12-lead ECG information via the FHIR system within 5 minutes. An automated FHIR-based 12-lead ECG mobile alert system successfully transmitted 94% of alerts within 5 minutes for patients with suspected acute coronary syndrome in the emergency department.
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