Tele-ECG and 24-hour physician support over telephone for rural doctors can help early treatment of acute myocardial infarction in rural areas

We observed that many patients of acute myocardial infarction (AMI) were reaching our hospital out of the 12 hour window period for thrombolysis. This led to poor patient outcomes. There were multiple reasons for the delay, prominent among them was lack of diagnostic facilities in the rural health care centers. We therefore planned a Tele-Electrocardiography (Tele-ECG) based pilot project in Kangra District of Himachal Pradesh in India, which was funded by the Indian Council of Medical Research. The intention was to reduce the pre-hospital delay in AMI by enabling the rural doctors of Kangra using Tele-ECG facility and a 24-hour physician support to manage patients of AMI. We did a baseline knowledge, attitude, and practice (KAP) assessment study of the doctors in our intervention centers to understand their needs. The data obtained through the KAP study was an eye opener for us and justifies the need for a Tele-ECG facility for rural doctors in India.