Update on Mission: Lifeline Boston University Medical Center STEMI Systems of Care: Update on Mission: Lifeline Alice K. Jacobs, M.D. Boston University Medical Center Boston, MA

Alice K. Jacobs, MD Grants/Contracted Research Abiomed, Inc. Accumetrics, Inc. Abbott Vascular

Disclosure Information FINANCIAL DISCLOSURE: Research Support: Abbott Vascular, Abiomed, Accumetrics UNLABELED/UNAPPROVED USES DISCLOSURE: None

Community-based National initiative Improve quality of care + outcomes in STEMI Improve healthcare system readiness and response to STEMI

May 30, 2007 Conference Proceedings published in Circulation and Mission: Lifeline Launched

Developing Systems of Care for STEMI

Status Report: February 2011 EMS System Assessment and Improvement Evaluate Existing Models Establish Local Initiatives Explore Possibility of National STEMI Certification

EMS System Survey

Response Rates Responses Overall: N=5415 By Region of the US Northeast: 26% Midwest: 36% South: 26% West: 12%

Pre-hospital 12-Lead ECG Percentage of Vehicles with 12-Lead ECG devices Responders Trained to Interpret 12-Lead ECG for STEMI 10

Destination Protocol for Pre-hospital Identification of STEMI Patients All Respondents Respondents Serving a Rural County 11

Have You Registered Your STEMI System with Mission: Lifeline?

Mission: Lifeline Social Networking Community http://mlcommunity.heart.org Registration: Every individual user will need to set up a log in and password. This is located in the middle of the welcome page. After log- in, the user will receive a welcome email that states the purpose of the site. Each new user will receive 2 welcome emails, please be sure to check the spam 15 15

Establishing Local Initiatives Task force members: Patients and care givers Physicians, nurses and other providers Payers EMS PCI capable and non-PCI capable hospitals Department of Health Rural health association Quality improvement organizations State and local policymakers OPTIONAL SLIDE: slide could be used with volunteers and external partners

Role of Public Policy in the Development of STEMI Systems of Care 2011 AHA State Legislative/Regulatory Priority AHA Model Legislation: HEart Attack Response and Treatment Act (HEART Act)

AHA Model Legislation: HEart Attack Response and Treatment Act (HEART Act) Section 3. A Statewide System for Heart Attack Response and Treatment Must be consistent with ACC/AHA guidelines Must have a community perspective Components Hospital Classification EMS Equipment and training Transport and transfer Continuous quality improvement Data collection and analysis ACTION Registry – Get With The Guidelines

National STEMI Certification Program Criteria posted on website: The American Heart Association has developed recommendations for a STEMI participation, recognition, and certification program for the system and each system component (STEMI Referral and Receiving Centers, EMS System Certification) Criteria posted on website: www.americanheart.org/missionlifeline

Active Sites = 621 Last updated: 9/22/2010 WA (9) VT (0) ME (1) MT (2) ND (1) MI NH (1) MN (6) OR (10) NY (21) MA (7) SD (3) WI (9) ID (2) MI (11) RI (2) WY (0) PA (29) CT (7) IA (6) NJ (8) NE (6) OH (33) DE (1) NV (7) IL (38) IN (19) WV (1) VA (17) MD (23) UT (2) CO (13) KS (10) MO (21) KY (5) DC (1) CA (40) NC (27) TN (20) OK (7) SC (15) AR (2) AZ (5) NM (3) AL (12) GA (14) MS (12) LA (9) TX (77) FL (36) AK (1) PR(2) HI (4) Last updated: 9/22/2010

Mission: Lifeline Reports 21

Mission: Lifeline Recognized Hospitals As of September 2010, 5 STEMI-Receiving hospitals have received a Silver Award 72 STEMI-Receiving hospitals have received a Bronze Award 22

Mission: Lifeline Recognized Hospitals These hospitals were recognized at AHA Sessions 2010 and were recognized in the August 2010 Mission: Lifeline US News and World Report Ad. 23

Priorities for 2011 Increase hospital and EMS and system participation Increase use of ARG, and enhanced ARG capabilities Increase number of hospitals with recognition Progress on certification Assessment of impact of Mission: Lifeline Focus on patient and public initiatives