The Department of Veterans Affairs is testing a new mobile handheld technology that enables off-site cardiologists to read EKGs
and use them to prescribe treatment within 3 minutes. For a patient awaiting
the arrival of an on-call cardiologist while in the ER or in a more remote
setting, this can be a lifesaving technology.
the American College of Cardiologist set a goal for 90 minutes
from arrival in the emergency room to treatment, and having access to specialists
within that time frame is vital to treatment success. The faster the patient
receives treatment, the better the outcome for the patient and the less time in
Dr. Divya Shroff, chief of staff
for informatics at the Washington, D.C., VA Medical Center, explains how the handheld device works: The ER
pages a cardiologist and sends an electronic EKG to the doc's mobile device. It
also cc's the electronic health record system, Vista. The
cardiologist receives the EKG alert and opens the file by pressing on an icon
and logging in. After reading and interpreting the image from a smartphone, the cardiologist clicks a "call" button to contact
the ER with a treatment orders. This all happens within 3 minutes.
Prior to the pilot phase, the VA tested the
technology internally. Of 600 EKGs read on a Blackberry mobile device,
were correct diagnoses. The correct diagnosis rate signals an exciting
reality for telehealth. Clear digital imaging offers new modes of
and treatment for remote patient populations that may lack access to
specialists, as well as more timely care in metropolitan and congested
areas. The smartphone EKG project exemplifies the potential for
The vendor that supplies the technology is mVisum
Mark Irish, mVisium's vice president of sales and marketing, describes
the company as a "communication platform," taking information like lab
results, CT scans, or emergent data, and creating a software vehicle
that data quickly and accurately to health providers on their mobile
device. The products, he says, are "pagers on steroids"-fast-tracking
information securely and efficiently.
In order to take advantage of the technology, the VA uses a
GE Muse server and digital EKG. The mVisum software knows when an EKG is taken
and grabs a copy (as does its internal EHR). If a call is placed regarding a
patient, the cardiologist can scroll through the EKGs, locating the patient of
interest and view the image off-site. Everything is server-based, so the EKG
does not reside on the phone-when the physician logs out, there is no
accessible data left on the phone.
HIPPA compliant, it is a fully
traceable process. The costs for this can range from $50,000-$75,000
annual maintenance fee, depending on factors such as the number of
users, existing hospital servers
and mobile device integration. The benefits, however, are clear:
reduced time to treatment for patients and improved care. As noted by
"The purchase price could be measured in just a few patients with
positive outcomes who will not require any of long term treatment."
Dr. Vasilios Papademetriou, a VA cardiologist, said the
training to use the technology is minimal-a 5-minute tutorial as
to how to use icons and menus on the mobile device. However, Papademetriou
feels that there are some areas that could see improvement such as how long
EKGs stay active on the Blackberry, and the need to refresh the device, which
can take several minutes. Also, he would like to see other lab values be
accessible to physicians on their devices. These are easy kinks to work out over the coming year, according to the VA staff.
Currently the Blackberry/EKG technology is being used in the D.C. Veterans Hospital. Dr. Shroff is hopeful that the use of the
technology will spread to all 153 VA medical centers across the nation.
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