Using technology  to raise the quality and lower the cost of primary healthcare cardiology service commissioning.

• Lower Costs
  We typically save a commissioning body at least 25% of total expenditure when compared to the current service provision
• Higher Quality Standards
  All ECG's are interpreted by cardiac physiologist ECG specialists within secondary/tertiary healthcare and audited by consultant cardiologists
• Reduce repeat testing
  All ECG's are stored centrally and are accessed across the local cardiac network
• Competive tendering
  ECG & holter recordings are analysed by the commissioners preferred NHS provider
• Pay as you go
  We store all ECG's recorded, however, you only pay for ECG analysis/reporting if you request it
• No capital investment required

			Einthoven ELI10	Typical hospital record & fax ECG service	Typical ECG reading service using 12-lead acoustic coupling device
Hardware Specifications	ECG signal sampling rate	The higher the sampling rate the higher the resolution of the recorded ECG. Higher sampling rates mean better quality ECG's which means a more acurate diagnostic result.	1000 Hz		375 Hz
	Interpretation algorithm	Not all computer algorithms are equal. The Veritas algorithm has been developed by David Mortara. David Mortara created the Marquette 12SL resting ECG interpretation program. Veritas is regarded by many as best ECG interpretation algorithm in class. Veritas is used by the FAA, FDA, NASA and in the majority of phase 1 clinical trials.	Veritas
	Recording format	All ECG channels are recorded in raw format for 10 seconds at 1000 Hz. Sometimes it is necessary to change the ECG rhythm strip channel in order to see the true rhythm. Because we store all channels for the full duration of the ECG, we can do this.	12 x 10s	12 x 2.5s + 1 x 10s	12 x 2.5s + 1 x 10s
	On-board Storage	The ELI-10 ECG machine can store 60 high resolution ECG's in its internal memory.	60 ECG's		1 ECG
	Rhythm screening mode	The ELI-10 ECG machine can be run in a simple rhythm check mode, allowing quick and detailed analysis of both rhythm and conduction status at a rate of 20 patients per hour.
Clinical Governance	Cardiac physiologist checking of all ECG measurements	We use best in class computer algorithms to measure all ECG measurements however a computer algorithm is not a substitute for an ECG expert. Accurate ECG measurements are critical when diagnosing complex cardiac conditions. All ECG measurements are checked and if necessary edited by skilled cardiac physiologists using a specially developed superimposition tool.
	Cardiac physiologist interpretation of ECG's	We use best in class computer algorithms to provide an initial ECG diagnosis. Although useful, a computer algorithm is not a substitute for an ECG expert. Computer algorithms tend to have high sensitivity but low selectivity. Over diagnosis by ECG algorithms is a major cause of inappropriate hospital referral. All computer ECG interpretations are checked and edited by skilled cardiac physiologists.
	Consultant cardiologist audit	Ongoing consultant cardiologist audit is employed to ensure the quality of the interpretation service. Each reporting cardiac physiologist is constantly monitored and scored for accuracy of ECG interpretation.
	Full audit trail	A full audit trail is kept of all data accesses and changes for all system users.
Clinical Utility	Selective ECG interpretation	All ECG's recorded are centrally stored however a commissioning body has the option to request and pay for only selected ECG interpretation. We would recommend that all primary care ECG's displaying an abnormal computer interpretation are over-read by a cardiac physiologist.
	Customisable algorithms for treatment pathways	To ensure standardised patient care across a commissioning group, user customisable algorithms are used to direct patients along a recommended care pathway dependent on the ECG findings. General practitioners are kept up to date with best current treatments.
	Immediate display of recorded ECG	The ECG is displayed in detail, before, during & after it is acquired on the ELI-10 LCD display and an unreported high resolution PDF ECG is instantly generated on data transmission.
	Live ECG interpretation and advice service	We understand there are times that you require an instant ECG opinion. Your analysis service provider is only a phone call away and will have access to all your ECG's so that instant opinion and advice may be given.
Clinical Utility	Barcode reader data entry	Patient demographics, including Read code data, can be quickly, easily and accurately attached to the ECG using a barcode reader.
	True patient record integration	You do not need to manually attach the ECG to the patient notes. We use the patient's NHS number on the patient's ECG to automatically attach the result to the patient's SystmOne record.
	Can be operated independently of computer workstation	The ECG machine is a completely mobile unit. It has an internal rechargeable power supply with an onboard ECG memory of 60 high resolution ECG's.
	Preservation of existing secondary care relationships	A commissioning body can integrate its local hospital into EINTHOVEN by appointing them to provide the required cardiology analysis, interpretation & clinical support services.
	End-user searchable central database	A patients complete ECG History can be accessed with a single click.
	Result available over entire cardiac network via NHS-N3 secure browser access	Results are posted to a secure NHS-N3 portal available to all members of the patient's authorised care network. Your patients ECG record will be available to the patient's local A&E department should they be admitted for a cardiac emergency.
Information Governance	Secure NHS-N3 transmission	Our software is designed so that patient data can only be viewed by authorised users. We will not lose your patient's data. We will not send your results to the wrong person. All NHS data is encrypted and sent via NHS-N3. Our transmission protocols are in compliance with current NHS data governance requirements.

We have made all efforts to check the accuracy of the data in the above table and believe it provides a fair basis for service comparison. Due to the constantly evolving nature of technology and the difficulty in obtaining accurate information from alternative service providers, you are advised and encouraged to independently verify the contents.

Julie Winterbottom, Business Manager from Westcliffe Medical Centre says, 

"Our new ECG record management system instantly alerts us of abnormal ECG results. This has helped us provide a better, more efficient service for our patients.  Until now, the technology has not existed to allow screening of all patients over 65 for potential heart conditions, but Technomed’s telemedicine software has made this possible.  We can now easily identify and fast track patients who would benefit from medical intervention and possibly prevent them from going on to develop life threatening health problems."

Telemedicine enables healthcare professionals to communicate and provide interactive medical care utilising modern technology and telecommunications.

Technomed work with healthcare providers such as HCA International to provide store-and-forward telemedicine to the UK’s private and NHS run hospitals and healthcare facilities.  Our remote monitoring solutions have a focus on cardiology problems.

Store-and-forward telemedicine allows a general practitioner to acquire medical data from an ECG or a 24 hour heart monitor test and then transmit the data to a cardiology specialist at a convenient time for analysis. The specialist then follows up with his diagnosis and recommended treatment plan. This highly efficient strategy allows the patient to be provided with expert care from their GP surgery without the need to be referred to hospital.

We enable first line cardiology testing, of the highest quality, to be carried out within a primary care environment faster and at a lower cost when compared to sending patients to hospital.

If you are commissioning a primary care cardiology service, our in-house development team will design and implement a system to efficiently deliver cardiology services to your primary care sites from your chosen secondary/tertiary care provider(s).

We provide training and support, install, create and look after the back end technology for all our clients.  We are constantly improving and evolving our software to keep up to date with new equipment or technologies that may need integrating into the system. 

Broomwell HealthWatch is a remote cardiology monitoring service provider. They are well known for their ECG reading service or Telemedical ECG service. Their contact details are: Broomwell HealthWatch Ltd., 86 Princess Street, Manchester, M1 6NG, telephone 0161 236 0141, 01612360141, e-mail health@broomwell.com