Digitalization of primary functional diagnostics data (example of electrocardiographic studies)

Authors: Morozov S.P.1, Vladzimirskiy A.V.1, Simenyura S.S.1, Demkina A.E.1, Shutov D.V. 1, Tyazhel’nikov A.A.2, Fokina E.V.2, Sadykova E.A.2

Company: 1Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies,Moscow, 109029, Russian Federation
2Consultative and Diagnostic Clinic # 121, Moscow, 117042, Russian Federation

For correspondence:  Sign in or register.

Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2020-14-1-16-23

For citation: Morozov S.P., Vladzimirskiy A.V., Simenyura S.S., Demkina A.E., Shutov D.V., Tyazhel’nikov A.A., Fokina E.V., Sadykova E.A. Digitalization of primary functional diagnostics data (example of electrocardiographic studies). Creative Cardiology. 2020; 14 (1): 16–23 (in Russ.). DOI: 10.24022/1997-3187-2020-14-1-16-23

Received / Accepted:  01.03.2020 /11.03.2020

Keywords: telemedicine technologies electrocardiography cardiovascular diseases

Full text:  

 

Abstract

Objective. To test the model of centralized collection and analysis of electrocardiograms (ECG) obtained at the primary care level using telemedicine technologies.
Materials and methods. The model was tested as part of a single-center pilot project held at Moscow State Budgetary Healthcare Institution Consulting and Diagnostic Polyclinic No. 121 of the Moscow Healthcare Department. At the first stage, 14,811 ECGs were recorded on thermal paper using analog devices (analog, A-ECG); at the second stage, 12,776 ECGs were obtained using digital devices and stored in the information system (tele-ECG, T-ECG). Research methods: timing for 60 ECG, comparative economic analysis.
Results. Centralization of the ECG reporting resulted in a significant increase in the total duration of the study stages from 180.0 ± 19.3 to 192.0 ± 13.1 sec, p = 0.0056. This is due to significantly more time required to enter patient data into the software when performing T-ECG as compared to A-ECG (p < 0.0001). At the same time, time savings due to centralization were shown at the stages of report preparation and sending (7.0 ± 2.2 sec for T-ECG vs 32.0 ± 3.7 sec for A-ECG; p < 0.0001) as well as the documentation completion (62.0 ± 5.3 sec for T-ECG vs 78.0 ± 7.0 sec for A-ECG, p < 0.0001). The study revealed a significant decrease in the total duration of ECG reporting (202.0 ± 24.0 sec for A-ECG vs 81.0 ± 7.6 sec for T-ECG, p < 0.001), with the greatest time savings for the radiologist when compiling a conclusion (113.0 ± 21.5 sec for A-ECG vs 15.0 ± 3.4 sec for T-ECG, p < 0.001). The use of T-ECG resulted in the total budget savings of 63,880 rubles.
Conclusion. The introduction of T-ECG in a city polyclinic with an extensive branch network resulted in the reduction of reporting time by 60.5%, reduction of the time between the ECG recording and result generation and entering it into the outpatient medical record form 2–5 to 1 working day, as well as the reduction of financial costs by 91.7%.

References

  1. Oganov R.G., Maslennikova G.Y. Demographic trends in the Russian Federation: the impact of cardiovascular disease. Cardiovascular Therapy and Prevention. 2012; 11 (1): 5–10. DOI: 10.15829/1728-8800-2012-1-5-10 (in Russ.).
  2. Boytsov S.A., Demkina A.E., Oshchepkova E.V., Dolgusheva Yu.A. Progress and problems of practical cardiology in Russia at the present stage. Kardiologiia. 2019; 59 (3): 53–9. DOI: 10.18087/cardio.2019.3.10242 (in Russ.).
  3. Boytsov S.A., Demkina A.E. Improving medical care for patients with diseases of the circulatory system in the framework of the Federal project “Combating cardiovascular diseases”. Upravleniye kachestvom v zdravookhranenii. 2019; 1: 26–33. https://e.uprzdrav.ru/?mid=33204 (accessed August 21, 2019) (in Russ.).
  4. Mishakin T.S. Improving the management of primary care level in a system of regional health services. Modern problems of science and education. 2012; 2: 320 (in Russ.).
  5. Mareev V.Yu., Fomin I.V., Ageev F.T. et al. Russian Heart Failure Society, Russian Society of Car-diology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia. 2018; 58 (6S): 8–158. DOI: 10.18087/cardio.2475 (in Russ.).
  6. Kobalava Zh.D., Konradi A.O., Nedogoda S.V. et al. Russian Society of Cardiology position paper on 2018 Guidelines of the European Society of Cardiology/European Society of Arterial Hypertension for the management of arterial hypertension. Russian Journal of Cardiology. 2018; 23 (12): 131–42. DOI: 10.15829/1560-4071-2018-12-131-142 (in Russ.).
  7. Badimon L., Vranckx P., Agewall S. et al. 2017 ESC Focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur. Heart J. 2017; 39 (3): 213–60.
  8. Bilalov F.S. Organization of clinical and diagnostic laboratories in outpatient medical organizations. Bashkortostan Medical Journal. 2017; 1 (67): 8–12 (in Russ.).
  9. Skvirskaya G.P. Actual problems of modernizing the primary health care system and improving the management of medical organizations. Head Physician. 2014; 11: 4–8 (in Russ.).
  10. Starodubov V.I., Kaliniskaya A.A., Shlyafer S.I. Primary care: state and development prospects Мoscow; 2007 (in Russ.).
  11. Apolikhin O.I., Shaderkin I.A., Perkhov V.I., Vladzymyrskiy A.V. Efficiency of the telemedicinebased population screening of prostate cancer. Current Problems of Health Care and Medical Statistics. 2018; 2: 72–85 (in Russ.).
  12. Vladzimirskiy A.V., Lebedev G.S. Telemedicina. Мoscow; 2018 (in Russ.).
  13. Revishvili A.Sh., Lomidze N.N., Khasanov I.Sh., Starikovskiy A.V. Рersonal telemonitoring: perspectives of development in arhythmology and cardiology. Kardiologiia. 2015; 12: 108–15 (in Russ.).
  14. Oleynikov V.E., Shitogarova E.A., Kulyutsin A.V., Evstigneev S.V. Improvement of rethrombosis diagnostics in steacs patients with use of telemonitoring of ECG. Russian Journal of Cardiology. 2014; 9 (113): 37–42. DOI: 10.15829/1560-4071-2014-9-37-42 (in Russ.).
  15. Boytsov S.A. Realities and prospects of remote blood pressure monitoring in hypertensive patients. Therapeutic Archive. 2018; 1: 4–8. DOI: 10.26442/terarkh20189014-8 (in Russ.).

About Authors

  • Sergey P. Morozov, Dr. Med. Sc., Professor, Director, ORCID
  • Anton V. Vladzimirskiy, Dr. Med. Sc., Professor, Deputy Director, ORCID
  • Sof’ya S. Simenyura, Junior Researcher, ORCID
  • Aleksandra E. Demkina, Cand. Med. Sc., Chief Researcher, ORCID
  • Dmitriy V. Shutov, Dr. Med. Sc., Researcher, ORCID
  • Andrey A. Tyazhel’nikov, Cand. Med. Sc., Chief Physician, ORCID
  • Elena V. Fokina, Functional Diagnostician, ORCID
  • Elina A. Sadykova, Functional Diagnostician, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery