AsistIAM: Innovating the Acute Coronary Syndrome Approach in Primary Care Settings

Area of Science:

• Cardiology
• Digital Health
• Primary Care Medicine

Background:

• Timely management of acute coronary syndrome (ACS) is crucial but challenging in rural primary care due to diagnostic and treatment barriers.
• Existing clinical guidelines are often better implemented in high-complexity hospital settings.
• This study addresses the need for improved ACS care in underserved areas.

Purpose of the Study:

• To develop and evaluate the usability of a mobile health (mHealth) application, AsistIAM, for assisting primary care physicians in the diagnosis and initial management of ACS.
• To assess the impact of the mHealth tool on clinical decision-making and identify barriers to ACS care.

Main Methods:

• Development of the AsistIAM mHealth tool with five modules: ECG interpretation, reperfusion strategies, risk assessment, georeferencing, and education.
• Usability assessment on a 1-7 scale in simulated and real-world conditions.
• A before-and-after study involving physicians in rural primary healthcare centers and a referral hospital, including pre- and post-implementation surveys on ACS care barriers.

Main Results:

• High mean usability scores for AsistIAM (6.52 in simulation, 6.18 in real-world), with high ratings for ease of learning, interface satisfaction, and function availability.
• Significant improvements reported by physicians post-implementation in ECG acquisition/interpretation (81.4%-100%), ST-elevation pattern recognition (25.6%-39.2%), referral center identification (88.1%-98.0%), and reduced errors in fibrinolytic use (44.1%-17.6%).

Conclusions:

• AsistIAM is an innovative mHealth tool that strengthens regional networks and enhances acute coronary syndrome management.
• The app's usability, intuitive interface, and practical utility support timely clinical decision-making in primary care settings.
• The findings suggest mHealth tools can effectively bridge gaps in cardiovascular care delivery in rural and primary care environments.