Patients were admitted into hospital through one of three ways: 211 patients arrived at the emergency department by their own means (group 1), 325 patients were delivered to the emergency department by ambulance (group 2) and 360 patients were taken straight to the catheterisation lab by ambulance (group 3).
For the third case, patients were able to go straight to the catheterisation lab because the ambulance doctors conducted diagnostic electrocardiograms (ECGs) upon arrival at the patient’s home or public place, and then sent the results of the ECG to cardiologists at the hospital using the free messaging service, WhatsApp on their smartphones.
The cardiologists at the hospital would confirm the diagnosis and prepare the catheterisation lab for the patient’s arrival, so they could bypass the emergency department, saving on average 50 minutes.
Results of the study were exemplary"Patients have the best chance of survival when they receive primary angioplasty to restore blood flow to blocked arteries within 90 minutes of contacting the health service," said lead author and cardiologist Dr Nicolás Lalor. "Numerous delays can occur before and after patients reach the hospital which lead to this treatment target being missed."
The researchers found that the time between symptom onset and treatment was significantly lower in group 3 (150 minutes) compared to groups 1 and 2 (200 minutes). Additionally, mortality was significantly lower in group 3 (0.83%) compared to groups 1 and 2 (3.17%).
Patients in group 3 also had a shorter hospital stay (4.88 days versus 5.58 days) and better left ventricular ejection fraction at discharge (51% versus 48%) than those in groups 1 and 2. The overall mortality rate of all STEMI patients in the study was 2.23%.
But, is this ethical – given the privacy concerns surrounding such apps?
WhatsApp announced on the 17 October that it would be releasing a location-sharing service on its app that allows users to track each other in real-time. Previously, WhatsApp only allowed its users to share their location as a one-off. Now the feature is more of a tracker. This has raised concerns over privacy and the potential for stalkers, companies and individuals, as users do not want their location be known, being privy to the information.
This also poses the risk of insurance companies and potential employers somehow getting a hold of the information. As of 2016 there were more than 165,000 health and wellness apps available, and the vast majority are not regulated in how they collect, save and share user’s personal.
This is because of the usual government policies that set rigid boundaries on how personal medical data is shared between traditional clinical settings and those outside of this are a long and complex process.
While for some companies going through the long process of achieving this approval is worth it, as the app then becomes covered by insurance, the vast majority simply provide “helpful hints” according to medical media expert Kirsten Ostherr, instead of actual medical intervention.
"Members of the general public, including patients, have begun to play a newly important role in collecting data about health and disease," remarked Ostherr. “With the rise of mobile apps and the growth of smartphone and wearable-device use, people's daily lives have become experiments 'in the wild.'"
While this is good as it offers researchers the opportunity to observe health data within the real world, the likelihood of this data actually reaching the doctor and making a difference to the patient’s care is, according to Ostherr, "almost nil.”
Policymakers: Trying to make the situation as legal and safe as possibleLast week, European Union lawmakers voted to bring WhatsApp and Skype under the strictest telecommunications privacy laws, which will restrict how they can track users. Under the ruling, app companies will have to guarantee the confidentiality of the customers’ communications and ask for users’ consent before tracking them online.
The deal is not final, however, as many member states are against it saying the judgement is weighted too heavily for privacy and will restrict digital innovation. Many others such as the European Parliament’s civil liberties committee have praised the move.
Ultimately, as echoed by Professor Michel Komajda, director of the European Society of Cardiology in Argentina, "time delay to treatment has a significant impact on survival of patients with STEMI. This study highlights one strategy to reduce delays.”
"Using on a smartphone is a cheap and easy way for ambulance and hospital doctors to communicate and we will be rolling this procedure out to other hospitals in Argentina," said Lalor. MIMS
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