Enhancing Rural Health Via Cardiovascular Telehealth for Rural Patients (E-VICTORS) Project
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 215
- 试验地点
- 4
- 主要终点
- Number of Emergency Department (ED) utilization
研究概览
简要总结
This pre-post study will evaluate the implementation of a cardiovascular telehealth platform, which will connect experts from the Wake Forest University Health Sciences (WFUHS) tertiary care center with Wilkes County Emergency Medical Services (WC-EMS) system, Wilkes Medical Center Emergency Department (ED), and The Wilkes County Health Department Public Health Community Clinic (PHCC) to improve cardiovascular care in this rural community.
详细描述
This program aims to improve cardiovascular care for patients in Wilkes County by implementing a cardiovascular telehealth program designed to; a) assist WC- EMS paramedics with the early risk stratification (electrocardiogram (EKG) interpretation, vital signs, and risk scores), treatment, and transportation destination decisions in patients with acute chest pain or dyspnea, b) support Wilkes Medical Center (WMC) Emergency Department (ED) providers (physicians and advanced practice clinicians) in the evaluation, management, and disposition of patients with acute cardiovascular symptoms, and c) provide consultative expertise to the Primary Health Care Centers (PHCC) for patients seen following an EMS or ED encounter for cardiovascular symptoms.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •age > 18 years at time of index encounter
- •Cardiovascular symptoms (chest discomfort or dyspnea consistent with possible ACS) as indicated by the treating provider
排除标准
- •Traumatic chest pain
- •Dyspnea that is clearly from a non-cardiac etiology
- •Patients with hemodynamic instability SBP < 90 mmHg, HR>160 or <40 bpm
- •Patients requiring intubation/mechanical ventilation
研究组 & 干预措施
Quality Surveillance Data
For this quality surveillance study, data will be collected retrospectively through electronic health record (EHR) queries for all eligible patients treated for acute cardiovascular symptoms by one of the study sites.
干预措施: Quality Surveillance Data Collection (Other)
结局指标
主要结局
Number of Emergency Department (ED) utilization
时间窗: baseline
ED utilization among patients with cardiovascular symptoms will be defined as the total number of cardiovascular-related ED admissions divided by the total number of unique individual patients receiving cardiovascular care during the project period.
次要结局
- Change in Cost - provider level(day 30 and Month 12)
- Number of Cardiovascular Inter-facility transfers(Baseline)
- Number of 30-day cardiovascular hospital re-admissions(day 30)
- Number of Cardiovascular hospitalizations(Baseline)
- Number of 30-day cardiovascular Emergency Department (ED) re-admissions(day 30)
- Cost-effectiveness(Month 12 and Month 48)
- Number of Adverse Events(day 30 and Month 12)
- Cardiovascular telehealth adoption rate(Month 12)
- Change in Cost - societal level(day 30 and Month 12)
- Cardiovascular telehealth consultation rate(Baseline)
- Cardiovascular telehealth sustainability rate(Month 24 - Month 48 post Intervention)