New digital platform gets clinicians on the same page when treating heart attacks

Closing STEMI team communication gaps

For STEMI patients, every minute counts. Clinical guidelines emphasize minimizing the time from first medical contact to coronary reperfusion because rapid restoration of blood flow can limit heart muscle damage and improve survival. Pineda said traditional activation methods often relied on pagers and phone calls, providing little clinical context to cath lab teams being called into the hospital, particularly during overnight hours.

Using STEMIcathAID, emergency department physicians can securely photograph and transmit an electrocardiogram (ECG) directly to the on-call interventional cardiologist. The cardiologist receives an immediate alert, reviews the tracing and contacts the emergency physician to discuss the case.

"The interventional cardiologist can see the ECG on their device, have the direct contact number for the emergency room physician and have that clinical conversation to make sure that this patient is appropriate to bring to the cath lab," Pineda said.

Once the cardiologist confirms a STEMI diagnosis and accepts the patient for catheterization, a single-button activation triggers notifications across the care continuum.

Human oversight remains central

Although artificial intelligence is increasingly being used to interpret ECGs and identify potential STEMI cases, the current version of STEMIcathAID does not include automated ECG analysis.

"We started this project in 2018 and went live in 2021, so we don't currently have the algorithm to look at ECGs," Pineda said. "That technology is available, and it's something that we're very interested in utilizing."

Instead, the system relies on physician review to prevent inappropriate cath lab activations.

"It's a rules-based system," he explained. "The cardiologist looks at it, identifies STEMI and has the clinical conversation. There are two clinicians in the loop really making sure that this patient is appropriate."

This approach helps avoid unnecessary middle-of-the-night activations while ensuring patients who truly need emergency intervention are treated without delay.

Beyond cath lab activation

Pineda said one of the platform's biggest advantages is the ability to provide richer clinical information to all members of the care team. Rather than receiving only a callback number through a pager system, clinicians can access patient vital signs, care discussion chats and procedural planning information within a single HIPAA-compliant platform. The system also facilitates planning for potential escalation to advanced therapies such as mechanical circulatory support.

"Having this richness of information not only allows us to do things faster, but also safer," Pineda said.

The coordination extends beyond the cath lab. ICU teams are alerted early, helping streamline patient transfers from the emergency department and then to intensive care recovery.

Positive data expands program across health system

What began as a pilot project focused on transfers between two hospitals has since expanded across the health system. Pineda said the app has now been used to help manage nearly 600 STEMI cases. After reviewing performance data from the first year of operation, Mount Sinai leaders decided to scale the platform to additional sites.

"The health system saw that there's a significant improvement," Pineda said. "There was a decision to scale that solution throughout the health system."