Use of a telemedical electrocardiogram by GPs in Manchester is said to have saved local hospitals £4m in the past year.
Every primary care trust in the Greater Manchester area is now using the telemedical ECG service from Broomwell Health Watch to diagnose patients with chest pains.
It allows GPs to carry out ECGs in their practices, instead of having to refer patients to hospital or a specialist provider.
The patient is hooked up to the device in the GP clinic. Readings are transmitted in an acoustic trace to an expert cardiac clinician by telephone.
The expert gives the GP a verbal diagnosis of whether the reading is abnormal or the patient needs to be referred to a specialist.
The verbal diagnosis is followed by a written assessment of the reading which can be integrated into the GP’s patient information system.
The service has now carried out more than 161,000 interpretations, which has in turn prevented 144,000 patients being referred to hospital.
Broomwell said this saves patients from stress and anxiety by avoiding a 10-day wait for a hospital appointment, as more than 90% can be treated in the primary care setting.
Broomwell said without having the test done by GPs, 63% of patients would typically end up being admitted to hospital through the A&E department.
In Manchester, use of the service has prevented 30,000 referrals to hospital. With each outpatient appointment costing around £155, it’s thought to have saved the Greater Manchester healthcare system £4.5m in the last year.
Karen Gibbons, service improvement manager at the Greater Manchester and Cheshire Cardiac and Stroke Network, which carried out the two year pilot, said preventing such a large number of referrals to secondary care was not only a positive for reducing costs.
“Providing this sort of expert diagnosis in a primary care setting not only generates cost and resource savings for the NHS, but it’s also more convenient for patients and ensures they benefit from timely and preventative care.”
© 2011 EHealth Media.
Sounds like hype or tripe?dyfthegog 162 weeks ago
I don't doubt that there are a few ECGs that need expert interpretation but the majority don't. It sounds to me as though all ECGs in Greater Manchester are being passed on to a specialist. This sounds like a huge waste of experience and time and is likely to be drawing someone away from a useful function. As usual from this sort of report, numbers are big but the article short of substance. This sort of puff wouldn't pass muster in medical journals and neither should it here.
In support of remote ECGs.Mike John Paynter 164 weeks ago
This telemed service has been in use in Somerset for the past 4 years, initially piloted in the minor injury and urgent care service and now in use across all of the County.
Within the minor injury and urgent care service more than 75% of all 'chest pain' and 'collapse query cause' patient presentations are managed as completed episodes and do not require onward referral to Secondary Care.
Clinical decision making and risk management is greatly enhanced by the use of this diagnostic service. It is impossible outside of the specialities of cardiology and emergency medicine for clinicians to remain competent in advanced 12 lead ECG interpretation.
Somerset Partnership NHS Foundation Trust
Begging the questionlayton 164 weeks ago
So - It is impossible outside of the specialities of cardiology and emergency medicine for clinicians to remain competent in advanced 12 lead ECG interpretation. But initial decision making in chest pain and collapse of unknown cause does not require advanced ECG interpretation. It does require basic ECG interpretation that should be well within the capability of any junior doctor or GP and is certainly not restricted to specialists in cardiology or emergency medicine.
Has this uncovered a more serious underlying problem in front-line diagnostics in terms of the experience and training of the personnel providing these services? And if 75% do not require onward referral did they actually need an urgent care service at all? It would be interesting to know in detail what was wrong with these patients and also the 25% that were referred on. Together, of course, with outcome data which is as rare in these threads as pink elephants.
Does not add uplayton 164 weeks ago
63% of patients having an ECG would have been admitted to hospital through A&E? I don't think so . . . For a start that would have meant around 400 admissions in Manchester through A&E just for an ECG. Hardly likely. Where do these numbers come from? Does anybody check or validate them?