Surviving a heart attack in rural locations always has been an iffy prospect. Long travel distances to the local hospital often thwart timely delivery of crucial clinical interventions or life-saving drugs. Hospital systems from Virginia to California are trying to harness the power of mobile technology to improve care — and, it's hoped, reduce mortality — for heart attack victims even before they get to the emergency department.

In July, 100-bed Howard Young Medical Center, Woodruff, Wis., and 25-bed critical access Eagle River (Wis.) Memorial Hospital, both part of Ministry Health Care, launched the Lifenet program. The system is designed by Physio-Control which, until earlier this year, was a division of Medtronic. It cost around $35,000 and allows paramedics to instantly send the results of a patient's 12-lead echocardiogram to emergency physicians awaiting the patient's arrival. Sentara Healthcare in Norfolk, Va., launched the system in February in partnership with local EMS councils. El Camino Hospital, Mountain View, Calif., deployed it in 2010.

"It cannot be overstated that when it comes to a heart attack, time is muscle," says Carl Hartman, M.D., medical director of Sentara Heart Hospital.

In large service areas like northern Wisconsin, every second counts. Roderick Brodhead, M.D., emergency services director for Howard Young and Eagle River, says getting timely information to clinicians lets them make quicker and better care decisions.

Cardiovascular disease is the No. 1 killer of Wisconsin's men and women of all races and ethnicities, totaling 32 percent of the state's annual deaths, according to a Wisconsin Heart Disease and Stroke Prevention Program 2010 report.

All hospital-associated 911-response vehicles are linked electronically to a bay station in the Howard Young emergency department. Once paramedics transmit a picture of an EKG, emergency physicians decide which treatments to have ready, Brodhead says.

The hospitals want to expand the service so paramedics can carry and administer thrombolytics. However, this is years away, he says, because the hospitals must study what type of training paramedics need to use these clot-busting drugs without any life-threatening complications.