In emergency rooms, where a difference of seconds can determine life or death, accurately assessing a patient’s symptoms and starting treatment quickly is critical. In reality, however, emergency departments often lack sufficient resources. To fill this gap, a startup has developed an artificial intelligence (AI) solution that supports emergency room triage based on ECG readings. The company is ARPI, a medical AI firm founded in 2021. ARPI’s “ECG Buddy,” now in place at more than 80 hospitals nationwide, is reshaping emergency room practice. The Korea Focus met with founder Professor Kim Joonghee of the Emergency Medicine Department at Seoul National University Bundang Hospital for details.

― What kind of company is ARPI?

“ARPI is a company launched in 2021 with the goal of creating Accurate, Robust, Practical, Innovative medical AI. The starting point was the aim to build ‘immediately usable technology’ that fits into a busy clinical workflow, and that remains the most important principle.”

― What is ECG Buddy, and why was it developed?

“ECG Buddy is a solution in which AI reads a ‘12-lead ECG’, a test that can be performed easily in the emergency room, and indicates what kind of problems the patient is most likely to have. It serves as a partner that supports accurate decision-making by emergency medical staff. An ECG is a basic test but contains a large amount of information. Precisely because of this, learning to interpret it properly is difficult. As an emergency physician, I have encountered and studied ECGs in clinical settings for many years, but they have always been challenging and frustrating. That frustration was the direct motivation for development. The core of ECG Buddy is to present the diverse clinical information that can be obtained from a single ECG in an intuitive format that can be grasped at a glance. To enhance accessibility, it is offered in multiple ways, from smartphone camera capture to integration with hospital information systems. It is designed for broad use in primary settings such as 119 emergency response sites and public health centers, as well as in university hospital emergency rooms.”

― In what situations is it most useful?

“Its largest role is at the triage stage when a patient first arrives at the emergency room. In the initial assessment of emergency patients, those with higher severity are selected first to receive monitoring and treatment. Blood pressure and pulse are taken and a brief history is obtained, but these alone are often insufficient to identify all critical patients, so ECGs are frequently performed. The problem is that emergency rooms lack the human resources for specialists to thoroughly review every ECG performed at this stage. As a result, many sites rely heavily on machine-generated reports, which increases the risk of missing important emergency findings that can be detected in ECGs. ECG Buddy is a tool that fills this structural gap.”

― How much can be learned from a single ECG?

“It covers representative emergency conditions such as myocardial infarction, pulmonary edema, and hyperkalemia. It simultaneously supports basic severity assessment, such as the risk of shock or cardiac arrest; cardiac function evaluation, including left and right ventricular function and pulmonary hypertension; and detection of arrhythmias requiring immediate intervention. In other words, at the initial ECG stage in the emergency room, it serves as both a safety net and a compass to support accurate and rapid diagnosis. In particular, for acute myocardial infarction, ECG Buddy has helped shorten the time from diagnosis to intervention by 8 minutes. For emergency treatment of hyperkalemia, drug administration time has been reduced by approximately 50 minutes compared to before.”

― How has the response been?

“Following successful implementation at Seoul National University Bundang Hospital, its adoption has expanded nationwide. ECG Buddy is currently integrated into the information systems of more than 80 hospitals and is being used in various clinical settings, including emergency rooms. Pilot use has also begun for guidance purposes by 119 emergency medical services. Overseas, the number of app users is gradually increasing, and in total, the service provides about 200,000 analyses per month.”

― What are the next steps?

“We recently launched ECG Buddy Clinic (EB Clinic). While ECG Buddy is focused on emergency care, EB Clinic is a service designed for health checkups and outpatient visits. ECG testing is increasingly used in health screenings, and with AI applied, five types of cardiovascular abnormalities can be assessed at once. In particular, it can evaluate the risk of hypertrophic cardiomyopathy (HCM), one of the major causes of sudden death, so demand in the screening and outpatient sectors is expected to be robust.”

― Any final points to emphasize?

“Although ECG Buddy plays an important role in emergency care, its use is currently limited to medical institutions where cardiology specialists are on staff. Considering the realities of emergency rooms, such tools in fact need to be available in all emergency departments. It is hoped that such regulations will be relaxed so that it can help enhance patient safety anywhere in the country.”

Popular News