Program designates hospitals for some heart attack patients

ST. LOUIS -- For Missourians suffering a particular type of serious heart attack, the nearest hospital may not be the best choice.

St. Louis Public Radio reported the Missouri Department of Health and Senior Services has designated 23 hospitals as the most comprehensive centers for the most serious heart attacks.

The so-called STEMI centers were compiled as part of a decade-long effort by the state to create a process known as Time-Critical Diagnosis System.

Missouri lawmakers established the system in 2008, and it was already active for time-sensitive health issues such as trauma and stroke.

Starting in May, the system also directs how emergency responders care for a certain type of serious heart attack called an ST-elevation myocardial infarction, in which a whole artery is plugged.

Typically, emergency responders prioritize distance in deciding where to take someone.

"Before this law, EMS was mandated to go to the closest hospital, and you couldn't bypass, you couldn't drive five more miles, even if you knew it was a better place for that patient," said Michael Lim, a cardiologist at Saint Louis University Hospital.

Under the Time-Critical Diagnosis System, patients are transported to the nearest qualified hospital, with the most serious patients going to those best-equipped to treat serious heart attacks.

Lim said the highest-level STEMI centers have around-the-clock lab capabilities and a high volume of heart attacks. Lower levels serve as entry points into the system and can stabilize more serious patients if needed.

Hospitals must apply to receive the STEMI designation. The state health department lists 23 Level I hospitals -- the highest designation -- including Saint Francis Medical Center and SoutheastHEALTH in Cape Girardeau. Thirty others also are part of the program, including Level II Poplar Bluff Regional Medical Center in Poplar Bluff, Missouri, and Level IV Perry County Memorial Hospital in Perryville, Missouri, and Ste. Genevieve County Memorial Hospital in Ste. Genevieve, Missouri.

The health department said all 53 hospitals that applied received the designation they sought.

The system was designed by Bill Jermyn, a former state emergency services director.

"He came to us and was talking about the 'golden hour'," said Ryan Barker, vice president of policy for the Missouri Foundation for Health. "After a heart attack or stroke, receiving the right care in the right place during that first hour is just so important. It saves heart tissue, it saves brain tissue. There so much riding on it."

Jermyn died of a heart attack while mowing his lawn in 2008. Days later, lawmakers voted unanimously to begin the process of implementing his idea across the state.

Information from: KWMU-FM, http://www.kwmu.org