NLM, researchers work on speeding AMI Tx
Informatics may speed thrombolytic administration
The National Library of Medicine (NLM) in Bethesda, MD, is funding 14 projects to accelerate life-saving treatment for acute myocardial infarction (AMI).
The projects will apply medical information science, or informatics, to the problem of gross under-utilization of the timely administration of thrombolytics.
"It is a joining of forces between the NLM and the National Heart, Lung, and Blood Institute at the National Institutes of Health," says Bob Mehnert, NLM program official. "They tell us the problem of delayed treatment isn’t resolved yet, despite numerous attempts to correct the situation. They thought the informatics approach might have something to offer."
Fleshed-out proposals will be submitted by mid-August.
The 14 tentative proposed projects:
• Massachusetts General Hospital in Bostonproposes to modify decision-making by emergency department (ED) personnel by exposing them to computerized scenarios simulating real-life situations that involve the user in decision-making on early management of AMI.
• Infinity Healthcare/National Heart Attack Information Consortium in Mequon, WI, proposes the creation of a National Emergency Medicine Extranet to improve AMI care by addressing the political, hardware, and software problems involved in using the Internet to address the problem nationally.
• Utilizing a database of clinical profiles, Web-based management aids, a case manager, and provision of relevant information to health care providers as needed, Massachusetts General Hospital plans to provide a continuum of care spanning home, clinic, and hospital for patients at risk for heart attack.
• Columbia University in New York City intends to link patients, and, as needed, professional personnel, to patients’ health care records for education and facilitate prompt, informed response to AMI symptoms. They will use the Web to provide patients and providers with access to their medical records.
• The University of Southern California in Los Angeles plans to use medical informatics and advanced communication technology for education of patients/public, pre-hospital/paramedic practitioners, and physicians/health care workers.
• UCLA intends to develop and evaluate a cardiac education module appropriate for patients, general practitioners, and remote specialists.
• The City of Las Vegas Department of Fire Services proposes to install and evaluate telemetry, including use of visual images and 12-lead EKGs for its responses to calls for emergency services.
• The University of Missouri at Columbia will develop a project to improve AMI care in rural EDs that uses informatics and telemedicine to provide training for physicians and connect them to specialists at a medical center.
• Engineering Management and Economics, Rockville, MD, proposes to develop "Listen to Your Heart," a suite of informatics-based tools to help reduce the time delay between initial symptoms suggestive of a heart attack and initiation of definitive medical work up and treatment.
• Brigham and Women’s Hospital in Boston plans to create patient-centered, computer-based decision support systems to help patients assess their risks of AMI and help them and bystanders decide when to seek emergency care.
• The University of Utah in Salt Lake City plans to review a variety of informatics technolo-gies for suitability in education and for improved efficiency with one or more aspects of the AMI therapy problem.
• The BE ALERT project of New England Research Institutes in Watertown, MA, plans education about heart attacks and thrombolytic therapy by creating educational material for patients and health-care providers, using innovative electronic educational materials and emergency hotlines.
• New England Medical Center in Boston plans a controlled clinical trial to evaluate the value of 12-lead EKGs with the addition of com-puterized predictive instruments during pre-hos-pital transport and treatment.
• The University of Michigan in Ann Arbor plans to provide widespread public education by developing an interactive multimedia Heart Attack Alert channel for use on 100 existing kiosks located in libraries, work sites, churches, shopping malls, and other sites convenient to the public.
Go to www.nlm.nih.gov on the Internet for more information on the projects.
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