Clinical Informatics

Pre-hospital Thrombolysis and Telemedicine in the NHS: A Business Case and Appraisal of the Literature


  1. Introduction and Definitions of Business Case, Telemedicine and Thrombolysis

  2. Strategic context in the NHS

    1. Previous treatment strategy in the NHS
    2. Achieving NHS Targets

  3. Objectives and Stakeholders of Pre-hospital Thrombolysis

  4. Available Options for Pre-hospital Thrombolysis

    • Long List
    • Criteria for Short List
    • Short List

  5. Tabulated Appraisal of Short List

    1. Option 1
    2. Option 2 and 3

  6. Summary of Appraisals and Executive Summary

  7. References


Telemedicine has been in use widely over the past 30 years in the main stream in parallel with the "explosive" advancements in communication technology. However, its history can be traced back even further to the middle ages, where bonfires was used as a communication tool to transmit information on the spread of the bubonic plague quickly.(1)


However, before any new technology is used to provide a service for the patients in the National Health Service, a business case is required to:

"examine and weigh up the objectives and the expected patient benefits against the costs and risk of implementation of the technology using all the available evidence available at that point in time."

Telemedicine can be best defined as:

"the rapid access to shared and remote medical expertise by means of telecommunications and information technologies, no matter where the patient or the relevant information is located".(2)

Put simply, telemedicine is the practise of medicine at a distance with the assistance of the latest communication and information technologies.

Thrombolysis is define as:

"the treatment to break up abnormal blood clots that are obstructing blood flow"

In a heart attack, the obstruction occurs in the coronary arteries of the heart that supplies the heart muscles. Blockage would lead to hypoxic damage of the heart muscles, which is the cause of a heart attack.

The treatment of this would then be thrombolysis as defined earlier. This can be done mechanically via angioplasty or chemically with the use of a thrombolytic drug.


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Page Updated: 17 May, 2017

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