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Digitalisierung und Clinical Decision Tools

Digitalization and clinical decision tools

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Zusammenfassung

Die Digitalisierung in der Akutkardiologie entwickelt sich – analog zur Entwicklung in der Medizin – mit hoher Geschwindigkeit und wird unterstützt durch eine immer breitere Verfügbarkeit digitaler Strukturen und eine bessere Vernetzung der Informationstechnologiesysteme. Mögliche Anwendungen in der Versorgung von Patienten mit akutem Thoraxschmerz beginnen bereits in der prähospitalen Phase durch Übertragung des digitalen Elektrokardiogramms (EKG), aber auch durch telemedizinische Unterstützung und digitales Notfallmanagement, die zur Optimierung der Rettungswege und zur Verkürzung kritischer Zeitintervalle dienen. Die zunehmende Verbreitung und Akzeptanz von Leitlinien-Apps und klinischen Entscheidungshilfen sowie eingebetteten Kalkulatoren und elektronischen Scores helfen, die Leitlinienadhärenz und somit die Versorgungsqualität und Prognose zu verbessern. Insbesondere die Unterstützung der Bildanalyse, aber auch die Voraussage interventionsbedürftiger Koronarstenosen oder zukünftiger Koronarereignisse wie Herzinfarkt oder Tod haben ein enormes Potenzial, zumal die konventionellen Instrumente häufig suboptimale Ergebnisse liefern. Allerdings bestehen derzeit Barrieren in der schnellen Verbreitung entsprechender Entscheidungshilfen: Zulassungsrechtliche Vorschriften für Medizinprodukte, Datenschutzbestimmungen und weitere haftungsrechtliche Aspekte sind zu beachten.

Abstract

Digitalization in cardiovascular emergencies is rapidly evolving, analogous to the development in medicine, driven by the increasingly broader availability of digital structures and improved networks, electronic health records and the interconnectivity of systems. The potential use of digital health in patients with acute chest pain starts even in the prehospital phase with the transmission of a digital electrocardiogram (ECG) as well as telemedical support and digital emergency management, which facilitate optimization of the rescue pathways and reduce critical time intervals. The increasing dissemination and acceptance of guideline apps and clinical decision support tools as well as integrated calculators and electronic scores are anticipated to improve guideline adherence, translating into a better quality of treatment and improved outcomes. Implementation of artificial intelligence to support image analysis and also the prediction of coronary artery stenosis requiring interventional treatment or impending cardiovascular events, such as heart attacks or death, have an enormous potential especially as conventional instruments frequently yield suboptimal results; however, there are barriers to the rapid dissemination of corresponding decision aids, such as the regulatory rules related to approval as a medical product, data protection issues and other legal liability aspects, which must be considered.

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  1. Medizinische Klinik III, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland

    E. Giannitsis

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  1. C. Reich
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  2. N. Frey
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Correspondence to E. Giannitsis.

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C. Reich, N. Frey und E. Giannitsis geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Reich, C., Frey, N. & Giannitsis, E. Digitalisierung und Clinical Decision Tools. Herz (2024). https://doi.org/10.1007/s00059-024-05242-5

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