Field testing of a smartphone application for the pre-hospital transmission of electrocardiogram images

Heart attacks are a significant cause of death in the United States. In the case of an S-T segment-elevation myocardial infarction (STEMI), there is a direct correlation between time to treatment and patient outcome; earlier treatment is superior. The transmission of pre-hospital ECG images allows earlier activation of the STEMI treatment process as a doctor can diagnosis a STEMI by examining the electrocardiogram (ECG) image before the patient is actually present at the treatment facility. Currently, EMS personnel use expensive proprietary systems to transmit the ECG images from EMS to the accepting center, but this is a costly solution. This paper describes the optimization and testing of an iPhone application (app) that transmits the ECG image via technology that is significantly less expensive than existing commercial systems. To date, testing has revealed that the current version of the app outperforms image transmission compared to emailed (large file size) photos. The next step is comparative testing against commercially available systems. The results from this comparative testing will provide quantitative evidence of the efficacy and reliability of this low cost innovation compared to a much more expensive proprietary system.