Relevance. Current guidelines emphasize the importance of rapid restoration of coronary blood flow in Acute Coronary Syndrome (ACS). However, delivering patients from remote areas faces challenges due to transportation difficulties and the shortage of qualified specialists. Therefore, developing effective evacuation mechanisms becomes particularly important. Research objective: The aim of the study is to evaluate the effectiveness and clinical and economic justification of a medical triage system for patients with acute coronary syndrome for interhospital evacuation from hard-to-reach areas of the Amur Region based on an analysis of data from a prospective hospital registry. Materials and methods. An integrated remote consulting system was used to determine the priority and select the mode of transport (air or ground). The study is based on a prospective registry of 194 patients evacuated from hard-to-reach areas to a regional vascular center and a group of 174 patients treated in first- and second-level hospitals before the implementation of the DCDC system. Results. The patient assessment scale demonstrated good predictive power regarding hospital mortality (AUC = 0.797, p=0.042). Mortality among high-risk patients significantly decreased thanks to air evacuation, while the low-risk group was successfully transported by land without increased adverse consequences. Due to DCDC and the corresponding timely evacuation of patients by air transport, over 5 years it was possible to save 3.089 QALYs compared to 2.43 QALYs in the group of patients treated in level 1 and 2 hospitals before the introduction of the DCDC service in the region. Quality-adjusted life-year (QALY) assessment confirmed the advantage of evacuation strategies: patients evacuated by air retained more quality-adjusted life-years than those who were not evacuated by air. Discussion. The combined approach integrating telemedicine consultations and stratified evacuation strategy has been validated through research findings. Implementing this methodology contributes to reducing adverse event risks and optimizing healthcare resource utilization. Conclusion. In remote healthcare settings, the proposed approach—combining teleconsultation with the selection of the most appropriate type of medical evacuation—ensures adherence to time standards for acute coronary syndrome (ACS) management under conditions of limited accessibility and shortage of specialized personnel. By minimizing the risk of adverse clinical outcomes and optimizing the utilization of healthcare resources, this model substantially enhances the efficiency and timeliness of emergency care delivery. The experience described may serve as a valuable reference for regions with comparable geographic and infrastructural challenges.