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

  3. Objectives and Stakeholders of Pre-hospital Thrombolysis

  4. Available Options for Pre-hospital Thrombolysis

  5. Tabulated Appraisal of Short List

    1. Option 1
    2. Option 2 and 3

  6. Summary of Appraisals and Executive Summary

  7. References

Objectives and Stakeholders of Pre-hospital Thrombolysis in the NHS

The objectives of pre-hospital thrombolysis is self-explanatory and is as follows:

The objectives of pre-hospital thrombolysis

  1. To meet the national target of thrombolysis of eligible patients within 60 minutes of call for help and reduce overall mortality and morbidity associated with heart attacks.

  2. To do this in both rural and urban areas.

  3. To use Telemedicine and Information Technology to achieve this aim, in-line with the national Connecting for Health projects.

  4. To maximise the current available organisational facilities and skills of ambulance services staff.

  5. To organise a sustainable service with specific, measurable, achievable and relevant outcomes with a pre-set time element.

The stakeholders for such an endeavour in the NHS cuts across a whole spectrum of organisations and their sub-divisions. As such, the stakeholders are listed under large umbrella groups with their sub-divisions then in brackets.

Stakeholders in pre-hospital thrombolysis in the NHS

  1. Health Organisations (Department of Health, Strategic Health Authorities, Primary Care Trusts, National Health Service Trusts, Foundation Trusts, Ambulance Trusts).

  2. The Professional Bodies (Royal College of Physicians, The Royal College of Nursing, The Joint Royal Colleges Ambulance Liaison Committee, The Royal Pharmaceutical Society of Great Britain, The British Medical Informatics Society, The Paramedic Advisory Groups, Ambulance Service Associations).

  3. Clinical Staff (Cardiologists, Acute Medicine Physicians, Accident and Emergency Consultants, Coronary Care Unit Nurses, Paramedics, On-call Doctors, Regional Pharmacy Advisors, Information Technology Technicians).

  4. Audit and Technology Assessment Groups (National Institute of Clinical Excellence, Health Technology Assessment Authority, Audit Commission, CHI, Myocardial Infarction National Audit Project).

  5. Industry (Pharmacy, Information Technology, Telecommunications, Medical Devices and Standards).

  6. Patient Groups (Patient Group Direction Groups, Patient Advisory Groups, British Heart Foundation).

  7. Department of Health, Ambulance Trusts, NHS Trust and Foundation Trust Solicitors.

  8. Ethics Committees.


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Page Updated: 17 May, 2017

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