Wednesday, January 28, 2015

10 Must-Have Features When Selecting an ECG System

Sudden cardiac arrest is the leading medical cause of death in athletes. A simple electrocardiogram (ECG) is a cost-effective method for identifying those at risk, far more effective than a physical exam and a review of medical history. There are many ECG manufacturers, and picking the right system for your needs can be challenging. Many organizations using older equipment face unmet needs that have led to cluttered and inefficient filing cabinets filled with paper. To remedy this, they must re-invest in appropriate technology.

This article highlights 10 key capabilities that are important considerations for your long term ECG system needs.

1. Digital Data. Digitally capturing every data element, observation, ECG trace, physician note, echo measurement and so on provides the flexibility that allows you to meet future and changing needs. Digital data will support your efforts in assessing program efficacy, process improvement, reporting and research studies. Don’t settle for just a 12-lead printout!

2. Customized Demographic Fields. Every organization has unique data collection needs: parent’s email address, clinic identifiers, medical illness, exercise frequency and so on. Customizable options for text entry and selection from drop-down lists are essential.

3. American Heart Association (AHA) 14 Point PPE questionnaire. The AHA recommends including these questions in the athlete’s Pre-Participation Exam. Important findings should be annotated on the ECG. For example, presence of syncope or chest pain while exercising might lead to a different recommendation or a second look at an ECG feature.

4. Modern Interpretation Criteria: The Seattle Criteria. The expected abnormal ECG rate is about 2%. Blinded studies demonstrate that it is uncommon for any physician to consistently read every record with an accuracy of 98– 100%. Obsolete ECG criteria that routinely provide misleading and inaccurate interpretations can distract the physician and reduce reading accuracy. Automatic interpretation using the recent Seattle Criteria provides strong physician support, similar to a consulting cardiologist assist, increasing accuracy and confidence that subtle features are appropriately noted and diagnosed.

5. Network Friendly, HIPAA Secure, Distributed Physician Overreading. The reviewing physician is often not onsite, or a consulting cardiologist may be required. Easy and secure network sharing and review of the ECG and associated digital data is an important consideration.

6. Post-Test Demographic Editing and Data Entry. Blunders happen, and the system needs to support post-test editing of errors and omissions and the addition of late arriving information.

7. Confirmed ECG PDF. Following physician review, a confirmed PDF of the ECG is generally required for the medical records, referring family physician and family. The confirmed ECG should include the physician’s name, date of confirmation, ECG status (Normal, Abnormal, etc), and physician comments. Creating the confirmed ECG PDF requires the digital ECG data and software tools that support electronic over reading.

8. Pre-Loaded Demographic Data. In large screening events entering the patient demographic information may be a time burden. When available in advance, it can be extremely helpful to pre-load these data so that just a mouse click populates the data entry screen. Importing an Excel spreadsheet is a convenient and efficient mechanism for this task. 

9. Cohort Reporting. Easy creation of an Excel spreadsheet containing all demographic data, responses to AHA questions, ECG measurements, abnormalities found, doctor’s confirmation notes, billing information, echo measurements, and so on is fundamental for managing and improving the screening process and research.

10. Software Updates. Over the past few years the accuracy and effectiveness of the ECG in identifying athletes at risk has dramatically improved. False positive rates have fallen from 15-20% to about 2%. This is an exciting and productive time for research focused on improving the sensitivity and specificity of the athlete ECG to detect life threatening abnormalities. Be sure your system can easily be updated to benefit from new insights, and be sure your vendor is actively participating in ECG research.
Perhaps this comes as no surprise, CardeaScreen scores a perfect 10, and is extremely easy to use! Watch the CardeaScreen video below:

Sports Health offers the CardeaScreen as a solution to help identify young athletes who are at risk of cardiac issues, at pricing well below many other systems on the market.

View the CardeaScreen and call us to talk about how the CardeaScreen can be a solution for you.

This blog has been written by David Hadley, PhD. President, Cardea Associates, Inc. 

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