News
Cardiac telemedicine services cut hospitalisation
12 December 2007
Technology that enables a fast, accurate diagnosis of heart problems
by telephone, using an innovative handheld 12-lead electrocardiogram (ECG)
device, has dramatically cut the number of people having to go to
hospital for symptoms of chest pain.
The technology, developed by Manchester-based Broomwell HealthWatch,
allows patients with symptoms of chest pain, or possible heart problems,
to receive a full 12-lead ECG test at their local GP surgery within
minutes, instead of having to travel to a hospital or A&E department and
wait up to two weeks for results.
Broomwell's cardiac monitoring service provides non-specialist GPs
with expert cardiac diagnostic support. Practice nurses carry out ECG
readings and the results are transmitted as a sound signal by telephone
to a 24-hour monitoring centre in Manchester, whose staff provide an
immediate verbal evaluation, followed by a written report, emailed back
to the surgery in minutes.
In nearly 6000 tests carried out over 16 months, 88% of even
symptomatic patients were managed and reassured by their local GP, and
did not need hospitalisation. It is understood that without the service,
at least 50% of those would have been referred.
The pioneering service is currently in use at four primary care
trusts across Greater Manchester — North and Central districts of
Manchester PCT and Stockport and Bury PCTs. Since its launch in
September 2006 it has already been used with over 1,300 patients,
delivering cost savings and freeing up acute emergency healthcare
resources across the region.
Reports from the Greater Manchester and Cheshire (GMC) Cardiac
Network confirm that the 1,300 ECGs carried out within the primary care
setting have helped ease the burden on local acute hospitals and also
dramatically reduced the number of outpatient secondary care referrals.
Following the success of the initial one-year pilot, the cardiac
monitoring service is being rolled out to a further five PCTs within the
Greater Manchester and Cheshire network — Heywood, Middleton & Rochdale,
Oldham, Central & Easter Cheshire, Salford and Ashton Leigh & Wigan.
A six-month pilot of cardiac telemedicine services within Cumbria and
Lancashire has demonstrated the potential to save up to 90,000 A&E
visits, 45,000 hospital admissions and hundreds of lives each year in
England.
The pilot’s results also showed the minimum savings to the NHS from
the use of telemedical ECG tests are £46m per year, simply by cutting
unnecessary hospital admissions and A&E visits for symptoms of chest
pain. Broomwell believes savings of over £250m a year are achievable.
Data from the NHS pilot showed 82% of patients receiving ECGs did not
need to go to hospital (neither A&E nor outpatients) following the test,
giving rapid reassurance, and reducing stress and anxiety.
The results of the pilot also showed that this approach to ECG
monitoring can save hundreds of lives each year by early detection of
heart problems. Early detection is proven to help avoid irreversible
heart damage. A further benefit is that patients can be accurately
diagnosed within local healthcare settings instead of having to travel
to a hospital for testing.
Prestwich-based GP, Dr Jonathan Lieberman, had been using the system
for a couple of years and encouraged his PCT to take part in the pilot.
He said: “The system is great for use in diagnosing patients with chest
pain symptoms. As a rule, patients would be referred to the local
hospital outpatients department for an ECG to look for any signs of a
cardiac illness. Now I can do an on-the-spot test in my surgery and get
a simple phone call to tell me the extent of the cardiac problem and if
the patient needs to be admitted to hospital or not.”
Southampton City Primary Care Trust (PCT) is now also deploying the ECG
interpretation service. Chris Webb, Specialist and Clinical Equipment
Services Manager for Southampton City PCT said: “The Heartview
Professional service has proved to be an invaluable asset to Southampton
City PCT and there has been good support for the service from the PCT’s
cardiac team. Work is now under way to expand the usage into GP
practices. Delivering optimal patient care is the Trust’s priority and
having access to fast, expert advice on sometimes complex cardiac issues
is an invaluable aid.”
Broomwell were contracted to work with Southampton City PCT following
a successful bid to enter a European project sponsoring such
initiatives.
Joshua Rowe, managing director of Broomwell HealthWatch commented:
“This service is beneficial to all parties concerned. It’s great for
patients because of the convenience and peace of mind it delivers, and
great for the NHS because it cuts costs and frees up resources. I
believe this type of lifesaving service will play a vital role in the
future of the NHS.”
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