“Another barrier,” he added, “is competition, which is often intense between regional hospitals that need patient referrals for financial survival and are thus wary of standardized protocols and sharing data regarding transporting patients to and between hospitals.”

“But the data now clearly show that such programs are essential for regional high-quality care to save lives,” he said.

The program has been extended to other cardiovascular emergencies, such as out-of-hospital cardiac arrest and stroke, Dr. Granger noted.

Interventional cardiologist Dr. Louai Razzouk of NYU Langone Health in New York City, commented by email, “Regional systems of care for myocardial infarctions are critical, as not all hospitals have the same capabilities, nor should they, as this would not be financially feasible.”

“Hospitals that can treat a heart attack right away and have a cardiac catheterization laboratory available on call 24/7 are encouraged to work closely with EMS and other hospitals with lesser capabilities, in order to optimize patients’ outcomes and minimize the delay in opening up a newly blocked coronary artery,” he told Reuters Health.

“Competition is always a factor when hospitals decide to participate in these national initiatives,” said Dr. Razzouk, who was not involved in the study. “But healthy competition is also a good way to encourage improvement in care and promote communication and learning from each other’s pitfalls and successes.”

NYU Langone Health is part of Mission: Lifeline and other cardiac regional systems and registries, and received a Lifeline Gold STEMI Award in June 2018, Dr. Razzouk noted. “A new focus of the Mission: Lifeline in 2019 will be the rate of cardiac rehabilitation referral for our STEMI patients.”