Background: No definitive solution has been forthcoming for the often dangerously long interval between cardiac symptom onset and seeking medical care (patient “decision time”) in the pre-hospital setting. Implementation of telemedicine technology and characterization of its utilizers are examined for its efficacy in reducing this possibly life-threatening time lag.
Methods: Time-to-contact measurements during 1/1990-8/2013 (primary goal) were retrieved from the medical files of all members of a telemedical facility. Data on age, gender, medical history and main complaint throughout 2012 were analyzed (secondary goal).
Results: Of a total 928,913 calls, 445,878 (48%) were made ≤60 minutes from symptom onset. Importantly, 24% of all calls (220,837/928,913) were made in <15 minutes. Throughout 2012, more males contacted in ≤60 minutes compared with females (11,480/24327 [47%]), P<0.03. Members <60 years of age (2,889/5,717 [51%]) called significantly earlier than those >60 years (19,386/40,839 [47%]), P<0.001. Patients with a history of resuscitation and/or myocardial infarction contacted significantly more rapidly than those with other cardiac diseases. Over one-half of the patients with cardiac complaints contacted the call center ≤60 minutes from symptom onset, as did those who suffered physical trauma, but not patients with gastrointestinal symptoms or pain elsewhere. Time-to-contact following neurological signs and symptoms varied considerably, with convulsions and seizures being associated with the shortest intervals.
Conclusions: A telemedicine system with rapid accessibility and prompt triage is an additional promising strategy for shortening the interval between symptom onset and call for medical assistance.
