Figure 1.

(a) Delivery of ECG information through cloud computing system. When a STEMI patient is seen at a non-PCI-capable facility hospital (STEMI referring hospital), the ECG of the patients is sent by a traditional fax machine or website to our cloud computing system, which automatically directs the ECG image to the smart phone of the cardiologist on duty at the STEMI receiving center. ECG: electrocardiography; MMS: multimedia messaging service; PCI: percutaneous coronary intervention; SMS: short message service; STEMI: ST segment elevation myocardial infarction. (b) STEMI transfer protocol. Once the cardiologist on duty confirms the diagnosis and calls back the referral physician to ascertain the medical condition of patients, he informs the ED staff physician as well as the triage nurse and immediately activates the PCI team in the STEMI receiving center. When the patients arrive at the ED of the STEMI receiving center, the patients with Killip I and II statuses are sent directly to the catheterization laboratory for primary PCI without the consultation of the cardiologist on duty. The patients who present as Killip III and IV statuses are stabilized at the ED and receive PCI after the consultation of cardiologist on duty. ED: emergency department; PCI: percutaneous coronary intervention; STEMI: ST segment elevation myocardial infarction.