kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2021-10-4-106-111kpccz-1000Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ. Кардиология. Организация здравоохранения и общественное здоровьеORIGINAL STUDIES. Cardiology/publichealthRemote clinical quality management of endovascular careRemote clinical quality management of endovascular carehttps://orcid.org/0000-0001-7178-1260AbramovА. Yu.AbramovA. Yu.

Abramov Aleksey Yu., DMSi, Director of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Abramov Aleksey Yu., DMSi, Director of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0001-6529-372XKichaD. I.KichaD. I.

Kicha Dmitry I., DMSi, Professor of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Kicha Dmitry I., DMSi, Professor of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0003-3085-7729Goloshchapov-AksenovR. S.Goloshchapov-AksenovR. S.

Goloshchapov-Aksenov Roman S., DMSi, Associate Professor at the Department of Cardiology, X-ray Endovascular and Hybrid Methods of Diagnosis and Treatment of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Goloshchapov-Aksenov Roman S., DMSi, Associate Professor at the Department of Cardiology, X-ray Endovascular and Hybrid Methods of Diagnosis and Treatment of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

mzmo-endovascular@mail.ruhttps://orcid.org/0000-0001-9134-7189RukodayniyO. V.RukodayniyO. V.

Rukodayny Oleg V., DMSi, MBA, Acting Head of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Rukodayny Oleg V., DMSi, MBA, Acting Head of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0003-4975-9336NazarovА. М.NazarovA. M.

Nazarov Alexandr M., DMSi, Associate Professor, lecturer at the Department of Anesthesiology and Resuscitation of the Pediatric Faculty, Orenburg State Medical University

6, Sovetskaya St., Orenburg, 460000

Nazarov Alexandr M., DMSi, Associate Professor, lecturer at the Department of Anesthesiology and Resuscitation of the Pediatric Faculty, Orenburg State Medical University

6, Sovetskaya St., Orenburg, 460000

https://orcid.org/0000-0001-7274-0276KoledinskyА. G.KoledinskyA. G.

Koledinsky Anton G., Head of the Department of Cardiology, Endovascular and Hybrid Treatment of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Koledinsky Anton G., Head of the Department of Cardiology, Endovascular and Hybrid Treatment of the Medical Institute

6, Miklukho-Maklaya St., Moscow, 117198

Рeoples Friendship University of Russia (RUDN University)РоссияРeoples Friendship University of Russia (RUDN University)Russian FederationOrenburg State Medical UniversityРоссияOrenburg State Medical UniversityRussian Federation202121122021104106111Copyright © Abramov А.Y., Kicha D.I., Goloshchapov-Aksenov R.S., Rukodayniy O.V., Nazarov А.М., Koledinsky А.G., 20212021Abramov А.Y., Kicha D.I., Goloshchapov-Aksenov R.S., Rukodayniy O.V., Nazarov А.М., Koledinsky А.G.Abramov A.Y., Kicha D.I., Goloshchapov-Aksenov R.S., Rukodayniy O.V., Nazarov A.M., Koledinsky A.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1000Aim

Aim. To assess the effectiveness of remote clinical quality management of endovascular care.

Methods

Methods. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005.

Results

Results. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In AprilDecember 2020 it increased up to 71.6% (p<0.001). The frequency of performing PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005).

Conclusion

Conclusion. Remote clinical management based on telemedicine and mentoring process technologies contributes to improving the quality of endovascular care in MI.

Aim

Aim. To assess the effectiveness of remote clinical quality management of endovascular care.

Methods

Methods. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005.

Results

Results. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In AprilDecember 2020 it increased up to 71.6% (p<0.001). The frequency of performing PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005).

Conclusion

Conclusion. Remote clinical management based on telemedicine and mentoring process technologies contributes to improving the quality of endovascular care in MI.

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The authors declare that there are no conflicts of interest present.