AI-assisted STEMI triage system from ambulance to ER

ST-segment elevation myocardial infarction (STEMI) is a medical emergency, and early reperfusion with primary percutaneous coronary intervention (PPCI) is essential to improve the clinical outcomes of patients with STEMI. Previous studies have demonstrated that shortened door-to-balloon (D2B) times for STEMI patients undergoing PPCI significantly reduced mortality and morbidity rates. The correct and immediate diagnosis of acute myocardial infarction is essential in emergency and prehospital ambulance settings, especially in patients with atypical presentations. To improve this clinical problem, we have introduced the following systems:

In-hospital

Emergency intelligent myocardial infarction platform: An AI-assisted ECG diagnostic and high-risk scoring system used to calculate an "ASAP" score which identifies high-risk patients presenting with atypical symptoms.

Prehospital

Remote AI STEMI detecting system for prehospital ambulance 

An AI-assisted remote STEMI detection system used during ambulance to improve:

1. the proportion of patients with atypical symptoms who receive an ECG in a timely manner (within 10 minutes of arrival)
2. the timeliness and accuracy of diagnosing acute myocardial infarction in all emergency patients with an ECG
3. the rate of prehospital ECG performance and the accuracy of diagnosing acute myocardial infarction.

Achievements

• Prior to the introduction of AI, CMUH already had a shorter D2B time compared to other medical centers in Taiwan. The primary reason for integrating AI into our emergency department and prehospital environment is for self-improvement and to provide better medical services.
• The median D2B time decreased from 64.5 minutes to 53.2 minutes prior to Taiwan’s major COVID-19 epidemic periods.
• The percentage of patients with an atypical presentation undergoing a 12-lead ECG examination within ≤10 min of their presentation steadily increased from 24.0% to 63.4%.
• Acute myocardial infarction (AMI) mortality has also dropped over the last three years from 7.7% to 5.5%.
• The percentage of prehospital ECGs successfully recorded in our system before arriving at the hospital is 100%. The percentage of prehospital ECGs recorded within 10 min of the initial medical contact is 80%.

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