{"title":"Impact of telemedicine in STEMI care system: A five-year experience from Tamil Nadu, India.","authors":"Justin Paul Gnanaraj, Anne Princy Steaphen, Aravazhi R, Arul Subbaiah Arunachalam, Arumugam M A, Balaji Pandian Palani, Balamurugan Raveendiran, Balasubramanian Sundaram, Cecily Mary Majella, Jaisankar Perumal, Panniyammakal Jeemon, Karthikeyan Ganesan, Kannan Balasubramani, Kannan Kumaresan, Kannan Perumal, Kannan Radhakrishnan, Kumaran Srinivasan, Manohar Ganesan, Munusamy Tamilmani, Muralidharan Azhakesan, Nachiappan K, Nageswaran Piskala Mohandoss, Nambirajan Jayabalan, Nandakumaran Mohanan, Pachaiyappan Padmnabhan, Rafic Babu Mohamed, Ragothaman Sethumadhavan, Ravichandran Edwin, Sabapathy Kannappan, Selvarani Gnanamuthu, Senthil Raj Krishan, Shilpa Prabhakar Satish, Darez Ahamed, Radhakrishnan Jagannathan","doi":"10.25259/IJMR_348_24","DOIUrl":null,"url":null,"abstract":"<p><p>Background & objectives Timely reperfusion reduces mortality in ST-segment elevation myocardial infarction (STEMI). Telemedicine and social media have been shown to improve STEMI care in community settings as reported previously. We established a government-sponsored STEMI care system in the State of Tamil Nadu with a goal of enhancing guideline-directed revascularisation (GDR) in STEMI. This study aimed to improve GDR by networking non-percutaneous coronary intervention (PCI)-capable hospitals with PCI capable hospitals in a hub-and-spoke model and implementing telemedicine through social media groups. Methods Eighteen Government medical college hospitals were provided cardiac catheterisation laboratories and linked to 188 Taluk and non-PCI capable Government hospitals forming 18 STEMI clusters. Telemedicine guidance on STEMI management was provided through WhatsApp groups created for each cluster. Cumulative daily data on the number of STEMIs, the revascularisation provided, and mortality were collected through free online web forms. Annual cumulative data on STEMI volumes and GDR were analysed. Results A total of 71,907 individuals were treated for STEMI from 2019 to 2023. A 67 per cent annual increase in the total individuals treated for STEMI was observed. The proportion of individuals receiving pharmaco-invasive therapy (PIT) increased from 7.9 to 31.7 per cent. There was a 68 per cent increase in the individuals receiving primary PCI. The number of individuals without GDR decreased by 20 per cent. There was a 6.7-fold rise in the individuals referred from spoke to hub hospitals for catheter-based revascularization. Overall mortality showed a marginal decrease from 8.7 to 8.4 per cent. Interpretation & conclusions Findings of this study suggest that a government-sponsored STEMI care system in a hub-and-spoke model, guided by telemedicine through social media groups will improve GDR in STEMI care in developing nations.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"125-133"},"PeriodicalIF":2.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010787/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25259/IJMR_348_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background & objectives Timely reperfusion reduces mortality in ST-segment elevation myocardial infarction (STEMI). Telemedicine and social media have been shown to improve STEMI care in community settings as reported previously. We established a government-sponsored STEMI care system in the State of Tamil Nadu with a goal of enhancing guideline-directed revascularisation (GDR) in STEMI. This study aimed to improve GDR by networking non-percutaneous coronary intervention (PCI)-capable hospitals with PCI capable hospitals in a hub-and-spoke model and implementing telemedicine through social media groups. Methods Eighteen Government medical college hospitals were provided cardiac catheterisation laboratories and linked to 188 Taluk and non-PCI capable Government hospitals forming 18 STEMI clusters. Telemedicine guidance on STEMI management was provided through WhatsApp groups created for each cluster. Cumulative daily data on the number of STEMIs, the revascularisation provided, and mortality were collected through free online web forms. Annual cumulative data on STEMI volumes and GDR were analysed. Results A total of 71,907 individuals were treated for STEMI from 2019 to 2023. A 67 per cent annual increase in the total individuals treated for STEMI was observed. The proportion of individuals receiving pharmaco-invasive therapy (PIT) increased from 7.9 to 31.7 per cent. There was a 68 per cent increase in the individuals receiving primary PCI. The number of individuals without GDR decreased by 20 per cent. There was a 6.7-fold rise in the individuals referred from spoke to hub hospitals for catheter-based revascularization. Overall mortality showed a marginal decrease from 8.7 to 8.4 per cent. Interpretation & conclusions Findings of this study suggest that a government-sponsored STEMI care system in a hub-and-spoke model, guided by telemedicine through social media groups will improve GDR in STEMI care in developing nations.
期刊介绍：
The Indian Journal of Medical Research (IJMR) [ISSN 0971-5916] is one of the oldest medical Journals not only in India, but probably in Asia, as it started in the year 1913. The Journal was started as a quarterly (4 issues/year) in 1913 and made bimonthly (6 issues/year) in 1958. It became monthly (12 issues/year) in the year 1964.
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