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Taiwan Life AID- Heart saving starting before arrival

Heart disease has been the second leading cause of death in Taiwan for many years. It consumes a huge number of medical resources every year, especially acute myocardial infarction. Acute myocardial infarction (AMI) is a part of acute coronary syndrome (ACS), which including ST-segment elevation myocardial infarction (STEMI), Non-ST-segment elevation myocardial infarction (NSTEMI), etc. AMI causes acute myocardial damage with symptoms including chest pain, shortness of breath, and cold sweats, etc. AMI can be divided into STEMI and NSTEMI according to the patient's electrocardiogram (Electrocardiography, ECG/EKG) showing whether the ST segment rises or not. Among them, STEMI occupies the majority, and its mortality rate (8%) is also the most dangerous AMI among them.

Clinical “Unmet Need”:

What really affects myocardial viability is the “Symptoms to balloon (S2B)" after infarction.
Self-diagnosis is not easy, and patients often arrive at the hospital more than 2 hours late.
Pre-hospital diagnosis before the ambulance arrives allows the cardiac catheterization team to assemble and begin preparation earlier.

So far, CMUH has developed a pre-hospital STEMI detection system based on 12-lead ECG, which is the most crucial diagnostic basis for STEMI. This system aims to enable patients with STEMI to receive cardiac catheterization as soon as possible. The STEMI pre-hospital system is a masterpiece of cooperation between CMUH and QT Medical. This system combines the CMUH all-day STEMI prediction system and QT portable 12-lead ECG device, then cooperates with 14 fire departments in Taichung City and Nantou County. This system can detect symptoms of STEMI as soon as the patient gets into the ambulance and notify the hospital in advance to prepare for catheterization. It can reduce the time from symptom onset to blood circulation, significantly improving pre-hospital STEMI patients' survival rate.

▲ Thrombus block the coronary arteries results in myocardial necrosis. Early reperfusion is necessary to resuscitation the ischemic myocardium. Pre-hospital electrocardiogram (ECG) is a Class I recommendation in American heart association guidelines.

▲ This system combines the CMUH all-day STEMI prediction system and QT portable 12-lead ECG device, then cooperates with 14 fire departments in Taichung City and Nantou County. This system can detect symptoms of STEMI as soon as the patient gets into the ambulance and notify the hospital in advance to prepare for catheterization. It can reduce the time from symptom onset to blood circulation, significantly improving pre-hospital STEMI patients' survival rate.

▲ The STEMI pre-hospital system is a masterpiece of cooperation between CMUH and QT Medical.

▲ Operator could get the result of QT-ECG and AI prediction right away on the ambulance.

▲ This system can detect symptoms of STEMI as soon as the patient gets into the ambulance and notify the hospital in advance to prepare for catheterization. It can reduce the time from symptom onset to blood circulation, significantly improving pre-hospital STEMI patients' survival rate. The result was published on international SCI journal.

Number of usages:

Time interval: 2021.07.17 – 2022.08.31
Number of the patients / quantity: 442 / 619
Number of usages: 619

Achievements

Competitions:

2022 Taipei Biotechnology Award -- Cross-Domain Excellence : Bronze Award

Papers:

Chen KW, Wang YC, Liu MH, Tsai BY, Wu MY, Hsieh PH, Wei JT, Shih ESC, Shiao YT, Hwang MJ, Wu YL, Hsu KC, Chang KC. Artificial intelligence-assisted remote detection of ST-elevation myocardial infarction using a mini-12-lead electrocardiogram device in prehospital ambulance care.
Front Cardiovasc Med. 2022 Oct 14;9:1001982.
Wang YC, Chen KW, Tsai BY, Wu MY, Hsieh PH, Wei JT, Shih ESC, Shiao YT, Hwang MJ, Chang KC. Implementation of an All-Day Artificial Intelligence-Based Triage System to Accelerate Door-to-Balloon Times. Mayo Clin Proc. 2022 Nov 3:S0025-6196(22)00302-0.

International Conference Invited:

HIMSS APAC 2022 in Bali
Korea GICS 2022 Online Publication

Award:

National Innovation Award 19th, 2022
Taipei Biotec. Award, 2022

▲ National and international conference invited speech.

Remote monitor of home hemodialysis

The survival rate of home hemodialysis (HD) is similar to cadaver transplantation and better than traditional hemodialysis. The cost is 25 % reduced than traditional dialysis.

But, how to monitor the danger remotely is a big challenge!

CMUH remote monitor of home HD app solves the problem

Patients could get hemodialysis at home and physicians could monitor the process of dialysis remotely through the CMUH “Smart dialysis App,” which sent the critical value and dialysis conditions to physicians and caregivers. Home-hemodialysis has already been applied more than 10,000 times and could save 90 days a year for each patient without need of hospital arrival.

▲ Through the CMUH App, patients could get the information and record of home hemodialysis from “Smart dialysis App.”

▲ The critical value and dialysis conditions would be sent to the physicians’ and caregivers’ cell phone in real-time.

▲ By the help from ”Smart dialysis App,” the home-hemodialysis has already been applied more than 10,000 and could save 90 days a year for each patient without need of hospital arrival.

Smart Healthcare