Technology applied to the health sector has made immensely positive strides saving lives in the smartphone era – the proliferation of mobile phones within communities has resulted in faster response times than ever before. Emergency services can be notifiedof incidents significantly quicker with mobile phones than compared to landlines. Smartphone applications have offered the ability to pinpointthe location of callers with a clickof a button so that ambulances can arrive on scene as quickly as possible. Now, smartphones can even minimize unnecessary waiting times at the ER during emergencies.
It is only fitting that Israel’s (thestate affectionately nicknamed the ‘Start-up Nation’) national emergency medical, disaster, ambulance andblood bank service Magen DavidAdom (MDA) represents the pinnacleof this trend of life-saving devicesand applications. Dating back even further than the State of Israel itself, the organization continues until today as a global leader in EMS innovation, including through the development of smartphone applications that provide simple yet innovative solutions to some of the greatest challenges of modern ambulance services.
One of the Israeli organization’s most innovative and recent technological infrastructures is the ‘MDA Teams’ mobile application. With the goal of minimizing any unnecessary waiting or consultation times before ST-segment elevation myocardial infarction (STEMI) treatments, the app streamlines direct communication between field paramedics, responding ambulances, Magen David Adom dispatch centers, on-call cardiologists and receiving hospitals.
With the click of a button, MDA Teams transmits ECGs and patient vitals, combining the main methods used to bypass the time-consuming emergency department in cases of patients suffering acute myocardial infarction ECG showing ST-segment elevation: utilizing automated ECG/ computer interpretation of the ECG and easy transmission to the on-call cardiologists.
For an organization that boasts a 7.6 minutes average response time for ambulances (and half that time forFirst Responders) it is no surprise that Magen David Adom is also working to cut down on the vital minutes between diagnosing the patient and transporting them to any necessary procedures. Developed in collaboration with the intensive cardiac care units, the Magen David Adom technology has shortened the time from symptom onset to catheterization by nearly 40.3%.
The technology also represents a better process to record and document events securely and directly via the smartphone application. First, on-call cardiologists activate their app to indicate they are on-call. When a mobile intensive care unit is calledto a patient having a STEMI, the paramedic can choose the receiving hospitals from a list of hospitals with ICCU and cath labs available. Then, the paramedic can take the ECG and send it securely through the system, also eliminating the risk of a wrong ECG being transferred. The ECG is uploaded via cellular connection from the monitoring device to the patient’s file on the server. The app then sends the ECG directly from the patient’s file to the cardiologist.
Listed in the application are on-call cardiologists, event date and time, ambulance number, main complaint, nearest hospital, urgency level, region and address of the call and patient destination. App features also include documented calls between the paramedic, regional dispatch, medical consult centers, hospitals and on-call cardiologists, along with ECG record and mapped ambulance tracking during transport with the estimated time of arrival. In keeping with privacy standards, no phone numbers are shown on the dialing server.
According to Eli Jaffe, PhD, EMT-P, director of training, PR, volunteer activities, marketing and international relations for Magen David Adom, before the application’s development, Magen David Adom paramedics “used mobile phones to orally describe the patient, symptoms and the ECG. Since smartphones are currently widely used, transmission of the ECG is possible through personal messaging applications such as WhatsApp.”
But this method is not without risks, he noted. “The paramedic may accidentally send the wrong ECG from an earlier patient to the on-call cardiologist, or the paramedic could transmit the ECG to the wrong person, which could lead to a breach in patient confidentiality.”
Additionally, photos taken by phone when in a hurry transporting the patient often results in transmitting a blurry ECG. “These methods are neither effective, secure nor documented”, said Jaffe. “For a true reductionin the symptoms-to-balloon time, EMS-to-balloon time should have a secure, well documented and effective infrastructure.”
Given the grave importance of quick coronary intervention during the deadliest type of heart attack, the combination of clinical diagnosis by trained paramedics and streamlined transportation of the ECG and patient makes the process fast and efficient, substantially decreasing the chance of severe complications, neurological damage, disability and death.
With new smartphone technologies such as the MDA Teams application, such infrastructure is now available to emergency medical teams, yet again highlighting the advantages of mobile tech devices in effectively and efficiently saving lives.