Document scanning ECGs is an unfortunate reality for many hospitals. It does not manage ECGs, one of the most prolific diagnostic tests performed in a hospital, or other cardiopulmonary test results. While document scanning roughly satisfies the meaningful-use standard, it fails clinicians with its inherent delays, low-quality resolution, and lack of physician tools. It is, essentially, an expensive junk drawer where clinicians become frustrated and lose their patience.

ECG management solves all the problems of document scanning.

Delayed Access

While document scanning roughly satisfies the meaningful–use standard (diagnostic test results posted in the electronic health record (EHR) to give to the patient or for interoperability), document scanning comes with inherent delays. Most hospitals, because of a chronic backlog of patient records, scan documents into the EHR days after the patient is discharged. These delays lead to the question: How meaningful are scanned diagnostic test results if they cannot be used to manage a patient while the patient is still in the hospital?

ECG management, by contrast, transfers the ECG from the cardiograph to the management system in seconds.  Clinicians read in the management system from anywhere they access the hospital network, including their iPhones and iPads. Clinicians use electronic tools to enter interpretations, including pick-list favorites; they send confirmed results to the EHR with a single click. Those confirmed ECGs are immediately available to manage their patients while still in the hospital.

Low Quality

Beyond the delays, we often hear that the scanned ECGs look ‘bent’ or ‘crooked’ or ‘wrinkled.’ They are low quality. Additionally, scanned ECGs lose their diagnostic aspect. ECGs calibrate at 25 mm/second, 10 mm/mV.  Document scanning corrupts calibration as it is a picture of the ECG, one cannot use calipers on a scanned ECG.  Furthermore, the standard of care in ECG interpretation is to compare the current ECG to the previous ECG and comment on what has changed. This is only possible manually with document scanning. 

ECG management, on the other hand, paints the ECG on the screen from a raw-data file feed. The quality is the same as the printout from the cardiograph. Because the ECG contains raw data, electronic calipers for measurement corrections are available. All the patient’s previous ECGs are stored in the ECG management system, serial comparison of ECG results is automatic, thus easily satisfying the standard of care.

Expensive

Document scanning is labor intensive. Multiple workflow analyses demonstrate an average savings of $7 per ECG with an ECG management system in place. Automating ECG management allows skilled staff to focus on patient care.

Junk Drawer

Imagine a junk drawer in a kitchen. It contains pens and scissors and take-out menus and birthday candles and tape and a little bit of everything. To find any particular item often requires taking everything out of the junk drawer, which is always frustrating. By analogy, the media folder or image folder in the EHR is a junk drawer. All the otherwise orphaned diagnostic test results get jumbled together in one repository (ECGs mixed with stress tests mixed with cardiac rehab results, etc.). Finding a particular test result means opening many of them until the one in question is found. Clinicians are busy. They express frustration to us about how long it takes to find a particular test result in their EHR junk drawers; sometimes they give up.

ECG management, on the other hand, identifies all the cardiopulmonary modalities that apply to the patient in their own ‘buckets.’ Finding a particular ECG from a given date is simple. Clinicians use it; patient care is improved by it.

Document scanning thousands of ECGs every year into the EHR is an unfortunate reality for many hospitals.  Document scanning is an inefficient use of hospital resources and impedes the clinician workflow by its delays, lack of tools for study interpretation, and easy accessibility for study retrieval. ECG management is the real solution for achieving patient, physician, and staff satisfaction.