Abstract 278: Improvement to Pre-Hospital ECG Image Transmission by a Novel iPhone Application Utilizing Mobile Phone Signal Enhancement Technology

Introduction: Field transmission of pre-hospital ECG images to facilitate advance activation of the STEMI system of care has been shown to be effective in improving patient care and prognosis. Current commercial wireless ECG transmission systems available are effective, but are expensive to implement and maintain. Head to head testing was performed using an iPhone application to mediate ECG image transmission on three national cellular carriers in comparison to one commercial ECG transmission system. This resulted in comparable performance particularly in signal rich coverage environments contained three or greater bars. Hypothesis: An iPhone application that mediates pre-hospital ECG image transmission could be a cost effective alternative to current commercial systems incorporated in the pre-hospital STEMI system of care. Using a mobile phone signal booster could enhance application performance to consistently transmit in all signal coverage environments. Testing: The application was tested on three national cellular carriers with two commercial systems. Data was collected with and without the addition of the mobile phone signal booster at 75 waypoints covering the entire signal coverage environment. Application performance was determined by the average percentage of successful transmission and duration of transmission within the total signal coverage environment. Results: As shown in Figure 1, using the mobile phone signal booster resulted in marked improvements to successful transmission. Performance of the carriers under boosted conditions was merged, as the differences were not statistically significant enough to warrant differentiation. Within the signal-limited environment, the application displayed superior reliability to the two commercial systems, while in the signal rich environment it was comparable. Minimal improvement was also seen in the duration of transmission of the application, although it was more apparent within the signal limited environment than in the signal rich environment. Conclusion: The addition of the mobile phone signal booster enhances the performance of the iPhone application, allowing it to successfully transmit ECGs more consistently than commercial systems in all signal coverage environments.