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


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  17. Taher T, Fu Y, Wagner GS, et al. Aborted myocardial infarction in patients with ST-segment elevation: insights from the assessment of the safety and efficacy of a new thrombolytic regimen-3 trial electrocardiographic substudy. J Am Coll Cardiol 2004; 44:38–43.

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  20. Department of Health UK. NHS Plan. 2000.

  21. Royal College of Physician UK. Myocardial Infarction Audit Project (MINAP).

  22. Health Care Commission, UK. Thrombolysis - 60 minutes call to needle time.

  23. Royal College of Physician UK. How the NHS Manages Heart Attacks. 2004-2005.

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  28. The European Myocardial Infarction Project Group. Pre-hospital thrombolytic therapy in patients with suspected acute myocardial infarction. N Engl J Med 1993; 329:383-9.

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  30. Morrow DA, Antman EM, Sayah A, et al. Evaluation of the time saved by pre-hospital initiation of reteplase for ST-elevation myocardial infarction: results of the early retavase thrombolysis in myocardial infarction (ER-TIMI) 19 trial. J Am Coll Cardiol 2002; 3:40:71-7.

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  39. Health Technology Assessment, National Institute for Health Research, UK . Early thrombolysis for the treatment of acute myocardial infarction: a systematic review and economic evaluation. 2003; Vol. 7: No 15, Page 75


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