title: [Development of a virtual tool for monitoring quality of care in acute myocardial infarction via the Internet].
abstract: BACKGROUND
  Measurement of quality indicators contributes to monitoring the performance of initial treatment of ST-elevated myocardial infarction (STEMI).
  
  
  OBJECTIVE
  To develop a virtual tool to calculate performance indicators of initial treatment of STEMI online via the internet.
  
  
  METHODS
  We identified critical elements of the therapeutic process and formulated indicators in a retrospective pilot study, and developed a virtual tool for prospective data collection on initial treatment of STEMI. Rio de Janeiro hospitals with emergency care units were selected and invited to participate in the project. Online reports were developed to be accessed at www.qualiiam.icict.fiocruz.br/indicadores.php and analyzed.
  
  
  RESULTS
  Five hospitals agreed to participate in the project and monitored treatment of different numbers of patients with a diagnosis of STEMI (A = 7, B = 14, C = 16, D = 44 and E = 43). Aspirin was administered in 94.6% of cases, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in 76.1% and beta-blockers in 82.5%; 68.4% of patients with no contraindication received fibrinolysis. In no case was door-to-needle time less than 30 min, and mean time was 122 min. All patients admitted to hospitals with catheterization facilities underwent primary angioplasty; mean door-to-balloon time in these patients was 161 min; in only 28% was it less than 90 min.
  
  
  CONCLUSIONS
  The system can be used as a tool to monitor the performance of initial treatment of patients with STEMI. Analysis of these indicators in the future may help to evaluate the contribution of online reporting to the development of better treatment practices.
authors.affiliation: Laboratório de Informações em Saúde (LIS), Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. mbsrivas@gmail.com
authors.forename: Marcelo B
authors.initials: MB
authors.lastname: Rivas
authors.forename: Francisco
authors.initials: F
authors.lastname: Viacava
authors.forename: Fabio N
authors.initials: FN
authors.lastname: Gonçalves
authors.forename: Hegláucio S
authors.initials: HS
authors.lastname: Barros
authors.forename: Rodrigo S
authors.initials: RS
authors.lastname: Moreira
mesh_terms: D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010865:Pilot Projects; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies