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

Last updated: November 29, 2023
Sponsor: McMaster University
Overall Status: Completed

Phase

N/A

Condition

Angina

Blood Clots

Myocardial Ischemia

Treatment

SMART AMI APPLICATION

Clinical Study ID

NCT05290389
HAH-21-015
  • Ages > 18
  • All Genders

Study Summary

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.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Emergency Medicine physicians at hospitals and urgent care centres located in theHamilton, 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

Exclusion Criteria:

  • N/A

Study Design

Total Participants: 260
Treatment Group(s): 1
Primary Treatment: SMART AMI APPLICATION
Phase:
Study Start date:
April 04, 2022
Estimated Completion Date:
November 30, 2023

Study Description

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.

Connect with a study center

  • Brantford General Hospital

    Brantford, Ontario N3R 1G9
    Canada

    Site Not Available

  • Joseph Brant Hospital

    Burlington, Ontario L7S 0A2
    Canada

    Site Not Available

  • Haldimand War Memorial Hospital

    Dunnville, Ontario N1A 2P7
    Canada

    Site Not Available

  • Fort Erie Urgent Care Center

    Fort Erie, Ontario L2A 1Z2
    Canada

    Site Not Available

  • West Lincoln Memorial Hospital

    Grimsby, Ontario L3M 1P3
    Canada

    Site Not Available

  • West Haldimand General Hospital

    Hagersville, Ontario N0A 1H0
    Canada

    Site Not Available

  • Hamilton General Hospital

    Hamilton, Ontario L8L 2X2
    Canada

    Site Not Available

  • Juravinski Hospital

    Hamilton, Ontario L8V 1C3
    Canada

    Site Not Available

  • Main Street West UCC

    Hamilton, Ontario L8S 1A4
    Canada

    Site Not Available

  • St. Joseph's Hospital

    Hamilton, Ontario L8N 4A6
    Canada

    Site Not Available

  • St. Joseph's Urgent Care Center

    Hamilton, Ontario L8G 5E4
    Canada

    Site Not Available

  • Greater Niagara General Hospital

    Niagara Falls, Ontario L2E 6X2
    Canada

    Site Not Available

  • Willett Urgent Care Centre

    Paris, Ontario N3L 2M7
    Canada

    Site Not Available

  • Port Colborne Urgent Care Center

    Port Colborne, Ontario L3K 2N7
    Canada

    Site Not Available

  • Norfolk General Hospital

    Simcoe, Ontario N3Y 1T7
    Canada

    Site Not Available

  • St. Catharines General Hospital

    St. Catharines, Ontario L2S 0A9
    Canada

    Site Not Available

  • Welland County General Hospital

    Welland, Ontario L3B 4W6
    Canada

    Site Not Available

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