University of Minnesota Uses Telehealth to Treat Heart Attacks in the Field

Much like telestroke vehicles bring emergency treatment to stroke victims in the field, a new vehicle being developed by the University of Minnesota Department of Medicine aims to treat heart attack patients the same way.

The UM’s Minnesota Mobile Resuscitation Consortium (MMRC) is getting ready to roll out a mobile health van that can treat patients on the scene via extracorporeal membrane oxygenation (ECMO). The process uses a machine that oxygenates a patient’s blood outside the body, allowing the heart and lungs to recover, then pumps that blood back into the body through cannula.

The three-year, $1.8 million project is being funded in part by the Leona M. and Harry B. Helmsley Charitable Trust, a familiar source of donations for innovative connected health projects across the country. Officials hope to have the program up and running this summer.

The project is the brainchild of the MMRC, which was launched in 2015 to improve collaboration among healthcare providers in the Minneapolis-St. Paul community to combat cardiac arrest.

MMRC officials note that the common procedure for treating patients in cardiac distress is CPR, but if a patient’s heart rhythm isn’t returned to a sustainable rate within 30 minutes, they’re in a refractory period and need an ECMO machine to revive them. Every 10 minutes after that point reduces the survival rate by 15 percent to 25 percent.

So instead of bringing patient to the ECMO machine at the university, the university is bringing the machine to the patients.

“The idea was in order for us to treat as many people at any location regardless of the proximity to hospitals, we needed to put the hospital equipment and expertise into something that moves, and that was when the idea for the truck was created,” Demetri Yannopoulos, MD, director of UM’s Center for Resuscitation Medicine, said in a story published by the university.

Yannopoulos and his colleagues have shown in studies that a mobile ECMO program can boost survival rates for out-of-hospital cardiac arrests.

"The findings from the trial make an important statement that early implementation of ECMO is the enabling and necessary condition that allows further advanced targeted therapies to be delivered in those critical patients. In its absence, the life-saving treatment that follows is just not possible," Yannopoulos said in a 2020 release announcing the results on one such study.

"With our mobile teams and cardiac arrest toolkits, we are able to deliver the expertise and equipment needed to stabilize people suffering cardiac arrest within as little as 30 minutes," added MMRC President Jason Bartos, an assistant professor at the University of Minnesota Medical School. "The ability to deliver these life-saving capabilities so quickly and reach patients across the Twin Cities is a game changer in the treatment of cardiac arrest." 

The concept is very similar to that of telestroke vehicles, as well as mobile health vans and ambulances equipped with telemedicine technology, all aimed at bringing care to the patient instead of waiting for the patient to be brought to the nearest hospital.

“The telemedicine concept was that once the truck is out there, Dr. Bartos and Dr. Yannopoulos would be able to see everything happening in the truck,” said Kim Harkins, a program manager of the Center for Resuscitation Medicine. “There are cameras set up near the patient’s head and the cannulation site and a 3D image of the whole truck.”

With equipment on board and a virtual link to specialists at the hospital, Harkins said the mobile unit could help reduce heart attack deaths by 75 percent.