Verbesserung der regionalen Versorgungsqualität des akuten Herzinfarktes durch intelligentes Datenmanagement und Interoperabilität für Rettungswesen und Krankenhaus (InfarctCaRe); TP1: kardiologische Herzinfarktversorgung

Abstract

INTRODUCTION In Thuringia, Germany, mortality from acute myocardial infarction (AMI) exceeds the national average by 23.1%, with rural regions facing delayed and suboptimal care compared to urban areas. These challenges are compounded by demographic change, shortages of (specialist) physicians, regional structural weaknesses, insufficient medical coverage, and population decline. The InfarctCare project—part of the WeCare initiative (a joint project of the University Hospital Jena and Friedrich Schiller University Jena, funded by the German Federal Ministry of Education, Research, and Space under the program line “WIR! – Wandel durch Innovation in der Region”)—aims to mitigate the effects of demographic change and ensure sustainable, comprehensive healthcare delivery. To this end, InfarctCare seeks to strengthen rural healthcare infrastructure through innovative telemedical solutions that bridge medical research, technological development, and clinical practice. Specifically, the project develops a smart, privacy-compliant data platform integrating prehospital and in-hospital processes to enhance AMI care via automatated data transfer and feedback systems for primary care givers to improves scoring the correct diagnosis of AMI and the subsequent management. Its core objectives include establishing interoperability between different software platforms and evaluating process improvements in a rural pilot region (Saalfeld-Rudolstadt) compared with urban standard care (Jena City). In Thuringia, Germany, mortality from acute myocardial infarction (AMI) is 23.1% above the national average, with rural regions experiencing delayed and suboptimal care. These disparities are driven by demographic change, physician shortages, structural weaknesses, inadequate medical coverage, and population decline. The InfarctCare project—part of the WeCare initiative (University Hospital Jena and Friedrich Schiller University Jena, funded by the German Federal Ministry of Education, Research, and Space under “WIR! – Wandel durch Innovation in der Region”)—aims to counter these effects and promote sustainable, comprehensive healthcare. It strengthens rural infrastructure through telemedical solutions linking medical research, technological development and clinical practice. The project develops a smart, privacy-compliant data platform integrating prehospital and in-hospital processes to enhance AMI diagnosis and management via automated data transfer and feedback systems for primary care providers (Figure 1). Core objectives include establishing interoperability across software systems and assessing process improvements in a rural pilot region (Saalfeld-Rudolstadt) compared with urban standard care (Jena City). METHODS Between March 2023 and February 2025, a consortium comprising the University Hospital Jena, Ernst-Abbe-Hochschule Jena, Fraunhofer IDMT, and TAKWA GmbH developed an interoperable system for seamless data exchange from emergency call to hospital discharge. Thirteen stakeholder-derived user stories guided the design, incorporating quality metrics such as door-to-balloon time and mortality rates. Due to data protection constraints, testing was conducted in a simulated environment using mock patients. Real-time data interfaces were prototyped with patient monitors (e.g., Corpuls C3) and ECG simulators. Anonymized datasets from the Thuringian Infarct Network supported system validation. RESULTS The requirements analysis produced a comprehensive data model encompassing vital signs, treatments, and outcomes. Simulated case studies (n = 10) demonstrated effective documentation of therapies—including medication administration and stent placement—and continuous vital parameter monitoring. The system architecture supported automatic generation of quality indicators, reducing manual workload. Despite regulatory delays, pilot simulations confirmed system interoperability and usability (Figure 2). Visualization tools such as catheterization lab capacity maps and tabular quality management dashboards (e.g., time to first ECG) were successfully implemented. Although no real-patient deployment occurred, mock-based evaluations verified the system’s technical feasibility. Regional authorities expressed continued support for real-world implementation. CONCLUSION InfarctCare successfully developed and validated a prototype for digital, data-driven optimization of AMI care. Through intelligent, interoperable data management, the project addresses rural–urban disparities in treatment quality and timeliness. Simulated testing confirmed the platform’s technical readiness, establishing a foundation for future clinical deployment once data privacy issues are resolved. The approach demonstrates strong potential for scalable improvements in cardiovascular outcomes and more efficient resource allocation in structurally disadvantaged regions.