Impact of a Cloud-Based Care Coordination Platform on False Cardiac Catheterization Laboratory Activations and Unnecessary Team Mobilization: Retrospective Cohort Study.

BACKGROUND

Rapid activation of the cardiac catheterization laboratory (CCL) for ST-segment elevation myocardial infarction (STEMI) is essential to minimize time to reperfusion. However, system-wide efforts to reduce treatment delays have been accompanied by increased false activations, defined as activations that do not result in emergent coronary intervention. False activations contribute to unnecessary team mobilization (UTM), staff fatigue, workflow disruption, and inefficient resource use.

OBJECTIVE

This study aimed to evaluate whether the implementation of a cloud-based care coordination platform (Stenoa) was associated with reductions in false activations and UTMs at a high-volume tertiary cardiac center.

METHODS

In September 2021, the McGill University Health Centre implemented Stenoa, a mobile, cloud-based STEMI coordination platform enabling systematic case validation using electrocardiographic and clinical data. A retrospective cohort study was conducted, including all CCL activations between September 2020 and December 2022. Activations were grouped as preimplementation (group 0: September 2020 to September 2021) and postimplementation (group 1: September 2021 to December 2022) periods. A false activation was defined as a CCL activation followed by case cancellation before any procedure was performed. The primary outcome was the rate of UTM.

RESULTS

In total, 632 activations were analyzed (group 0: n=288; group 1: n=344). UTM decreased from 8.7% (23/265) to 4.4% (14/316) following platform implementation (P=.04). False activation frequency decreased from 10.2% (27/265) to 6.9% (22/316), although this difference did not reach statistical significance (P=.16). Among false activations, the proportion resulting in UTM declined from 85% to 63% (P=.08).

CONCLUSIONS

The implementation of a cloud-based STEMI coordination platform was associated with a significant reduction in unnecessary catheterization laboratory team mobilization. Structured digital communication may improve workflow efficiency and resource use in STEMI systems of care. Further multicenter evaluation is warranted.