INTRODUCTION
Ischemic Heart Disease (IHD) continues to be the single most common
cause of death worldwide. The estimated incidence of a myocardial
infarction (MI) in the US remains high and is approximately 605,000 new
attacks annually. MI and coronary heart disease were two of the ten most
expensive conditions treated in 2013 with an estimated total healthcare
cost of 218 billion dollars.1 Mortality rates have
declined in part due to timely percutaneous coronary interventions (PCI)
for ST segment elevation myocardial infarction (STEMI) but the burden
and risk factors remain significant.2 Guidelines
continue to evolve with increased emphasis on the rapidity of
infarcted-related coronary artery recanalization.3-5Health care systems continue to strive for improvement in door-to-first
ECG and door-to-balloon (D2B) times and the identification of system,
provider, and patient barriers is paramount to improved patient
outcomes.3,4,6-8