One Map to Guide Them All: The Physician Who Hopes to Connect the Cardiology Dots


One physician wants to explore far beyond the work of the likes of Lewis, Clark, Ptolemy, and even Google Earth. He wants to map every single one of the world’s cardiac catheterization laboratories.

The project is known as the Global Cardiology Mapping project and the mission, as creator Ivan Rokos, MD (University of California, Los Angeles), described it to TCTMD, is “no STEMI patient left behind.” The aim is to build a database of all of the PCI-capable hospitals around the world.

“The purpose and the goal is to crowdsource regional knowledge into one standardized and universally accessible database,” he said. “To begin with, it really celebrates all that’s been achieved by the cardiology community and the creation of these PCI hospitals around the world. But no one actually even knows how many PCI hospitals there are, and where exactly they are.”

The Global Cardiology Mapping Project is hosted by TCTMD, and all members can access it to enter information about their labs and hospitals. The entry form is a single page with fields for an address, hospital capability in primary PCI, CABG, TAVR, or transcatheter mitral valve replacement (TMVR). It also has fields to enter the names of the lab director and interventionalists.

The project emerged in 2006 when Rokos started mapping the 33 designated STEMI Receiving Centers (SRC) in Los Angeles County.

“The inspiration for that part was basically the creation of the STEMI receiving center,” Rokos said. “So that was the big emphasis to start thinking, ‘Well, wait a sec.’ Why can’t we organize our EMS system in LA County so that everybody diagnosed with STEMI is taken directly to a cath lab or a PCI-capable hospital rather than just to the nearest hospital, which was the default?’”

In 2007, Rokos presented an abstract at the Transcatheter Cardiovascular Therapeutics (TCT) symposium of the expanded project, which included four counties and about 60 SRC—a network of STEMI centers in California that served more than 16 million people. Eventually, Rokos and his team mapped every PCI hospital in the state.

Rokos is not an interventional cardiologist—or even a cartographer for that matter. He’s an emergency medicine physician based out of Olive View-UCLA Hospital, located just north of Los Angeles. His interest in the project comes from his belief that better hospital connections can lead to better health outcomes for patients, especially those suffering from MI. He calls it “macroanatomy.”

“I like to use that term because cardiologists define anatomy on a micro level, the microanatomy, the coronaries, etcetera,” said Rokos. By contrast, macroanatomy speaks to something on a regional, state, country-wide, or even global level. “And to deliver good care to patients, you kind of have to have this really big picture look on how the region is set up and getting and funneling patients to PCI hospitals,” he added.

After more than a decade of mapping hospitals, Rokos said he is eager to get help from physicians around the world for this project. In 2013, Rokos pitched the idea to TCT course director Gregg Stone, MD (Columbia University Medical Center, New York), following the annual congress. So far most of the mapping has been done by him and a data entry assistant, but he believes in the power of crowdsourcing. His goal is to get the whole cardiology community involved in the project.

As of now, more than 1,000 hospitals across four continents including parts of North America, Europe, Africa, and Asia have been mapped.

“When the STEMI care community works together via TCTMD, we can highlight existing resources, identify gaps, and then work to close those gaps, so that at the end of the day every STEMI patient [will be able to have] ideal reperfusion,” he said.

Michael H. Wilson is the 2016 recipient of the Jason Kahn Fellowship in Medical Journalism.

 

 

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