Effect of Digital platform to FMC (First Medical Contact) to refer out for primary PCI/fibrinolytic among ST-segment elevation myocardial infarction patients in Chaiyaphum province
Keywords:
First medical contact, ST-segment elevation myocardial infarction, percutaneous coronary intervention, Google formAbstract
Background: Patients with acute ST-segment elevation myocardial infarction (STEMI) require prompt treatment within 60 minutes to reduce mortality rates.
Objective: To compare the time taken for each step in the treatment of STEMI patients between using a digital platform and manual recording.
Method: A cross-sectional study using secondary data from 512 STEMI patients. Patients were divided into two groups: manual recording (n = 243, November 2021 – October 2022) and digital platform recording (Google form, n = 269, November 2022 – October 2023). Data were collected from admission to diagnosis confirmation, including 6 steps. Data were analyzed using repeated measure ANOVA.
Result: The manual recording group had an average data recording time of 162.20 minutes, while the Google Forms group had an average of 150.92 minutes. Manual recording took the longest time in the step from Confirm diagnosis to Refer out (81.26 minutes; 95% CI: 75.83, 86.69), followed by the step from EKG to diagnosis (47.70 minutes; 95% CI: 42.28, 53.13). Similarly, Google Forms took 61.92 minutes (95% CI: 56.76, 67.07) and 22.02 minutes (95% CI: 16.86, 27.17), respectively. Overall, Google Forms took significantly less time than manual recording (p-value < 0.001). The steps with the greatest difference were EKG to diagnosis (Mean diff. = 25.69; 95% CI: 18.20, 33.17), followed by Confirm diagnosis to Refer out (Mean diff. = 19.34; 95% CI: 11.85, 26.82). There was no statistically significant difference between the two methods in the step from admission to EKG (Mean diff. = 4.91; 95% CI: -2.57, 12.39).
Conclusions: The development of a digital platform can reduce the time to treatment for STEMI patients. However, this method does not yet meet the target of less than 60 minutes. Further development to reduce unnecessary processes and connect devices to the digital platform is a direction that should be promoted in the future.
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