Mat Goebel

Mat Goebel
University of Massachusetts Medical School - Baystate · Emergency Medicine

Doctor of Medicine

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9
Publications
279
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74
Citations

Publications

Publications (9)
Preprint
UNSTRUCTURED Health Level 7 (HL7) is a ubiquitous protocol in healthcare infrastructure, used to interface a variety of systems. HL7 lacks encryption at the level of the protocol, and is thus vulnerable to attacks that modify message contents. We describe a sophisticated man-in-the-middle attack that injects misinformation into clinical workflow th...
Article
Introduction ST-segment elevation myocardial infarction (STEMI) is a time-sensitive entity that has been shown to benefit from prehospital diagnosis by electrocardiogram (ECG). Current computer algorithms with binary decision making are not accurate enough to be relied on for cardiac catheterization lab (CCL) activation. Hypothesis An algorithmic...
Preprint
BACKGROUND 9-1-1 call centers are a critical component of prehospital care: they accept emergency calls, dispatch field responders such as EMS units, and provide callers with emergency medical instructions prior to their arrival. OBJECTIVE We aim to describe the technical structure of the 9-1-1 call taking system and describe its vulnerabilities t...
Article
Full-text available
Introduction: Prehospital acquisition of electrocardiograms (ECG) has been consistently associated with reduced door-to-balloon times in the treatment of ST-segment myocardial infarction (STEMI). There is little evidence establishing best hospital practices once the ECG has been received by the emergency department (ED). This study evaluates the u...
Article
Background: Left ventricular assist devices (LVADs) are used with increasing frequency and left in place for longer periods of time. Prior publications have focused on the mechanics of troubleshooting the device itself. We aim to describe the epidemiology of LVAD patient presentations to emergency medical services (EMS), prehospital assessments and...
Article
Background: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. Obje...
Article
Background: Limited work has established an objective measure of ECG quality that correlates with physician opinion of the study. We seek to establish a threshold of acceptable ECG data quality for the purpose of ruling out STEMI derived from emergency physician opinion. Methods: A panel of three emergency physicians rated 240 12-Lead ECGs as be...
Article
Continuous-flow left ventricular assist devices (LVADs) are increasingly implanted to support patients with end-stage heart failure. These patients are at high risk for complications, many of which necessitate emergency care. While rehospitalization rates have been described, there is little data regarding emergency department (ED) visits. We hypot...
Article
Certain acute coronary syndrome electrocardiographic (ECG) patterns, which do not include ST-segment elevation, are indicative of acute coronary syndrome caused by significant arterial occlusion; these patterns are, of course, associated with significant risk to the patient and mandate a rapid response from the health care team. One such high-risk...

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Projects (7)