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In Non PCI Hospitals

ED Role in Activation Of STEMI. In Non PCI Hospitals. Steve Schroeder MD Avera Hand County Memorial Hospital. Development of Rural STEMI Care. Disclaimer/Representation SDAFP-Primary care SDFMC- QIO responsibility Trauma system

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In Non PCI Hospitals

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  1. ED Role in Activation Of STEMI In Non PCI Hospitals Steve Schroeder MD Avera Hand County Memorial Hospital

  2. Development of Rural STEMI Care • Disclaimer/Representation SDAFP-Primary care SDFMC- QIO responsibility Trauma system • Process in typical Rural facility ie Miller • Evolving therapies • Transition of care • Telemedicine • Results of State Survey on STEMI

  3. HEALTH CARE

  4. Triage Time/Distance/Weather/Transport EMT Training/coverage Mid-levels

  5. Future Concerns and Opportunities • Complicated Non-STEMI MI • Cookbook Medicine/Practice variation • Regulatory Mandates • Public Reporting • Payer involvement • Collaboration/avoid Bias/Silo mentality

  6. Perfect Storm “Rural Areas” • Decreasing manpower • expense of recruitment • lack of preparation, training and • exposure to small town setting • reimbursement SGR, bundling, • capitation,ACO’s etc.

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