ECG integrating with the EMR

Northern Health’s Electronic Medical Record (EMR) will be integrated with our current electrocardiogram (ECG) records when we go live in September 2023.

An ECG records the electrical signals in the heart and is commonly used by patients who experience chest pain, heart palpitations, and rapid pulse, in order for the clinicians to detect or determine whether there are irregular heart rhythms, blocked or narrowed arteries in the heart that might be causing chest pain or potential of a heart attack.

Currently, at Northern Health, ECGs can be initiated by nurses or doctors, how and when these studies are reviewed is dependent on the patient’s clinical condition or where the patient is located. For example, in ICU, patients undergo regular ECGs in the mornings. The results are stored in the Philips monitors and are reviewed by consultants on the morning ward round. Generally, the ECGs are then printed and stored in the patient’s chart.

When the EMR is implemented, clinicians will be able to use Mortara Carts or Philips Bedside monitors to order and perform a 12 Lead ECG in the system. The image of the record will be sent to the archive and integrated with the patient’s record in the EMR. From there, our cardiologists will be able to enter their final interpretation and sign the order off. Doctors will also be able to view the results in ‘Results Review’ at their convenience. This will be a paperless process.

At the front and centre of designing this workflow, is Nader Elshehabi, EMR Benefits and Clinical Analyst. Coming from a medical background, Nader has worked as a practising doctor trained in Cardiology, and then as a Cerner consultant for many years. Before joining Northern Health’s EMR team, he helped implement EMRs in several hospitals overseas.

“Digitising the ECG workflow helps clinicians get instant access to current and all previous ECGs at the point of care. For example, cardiologists from Epping can immediately see and report on ECGs performed in other sites. They can also compare current ECGs with previous studies. This helps the care team make more informed clinical decisions, much faster,” says Nader.

The workflow was validated on 29 September 2022, with a live demonstration conducted by Nader at Northern Hospital’s ICU ward. To ensure patient safety and quality of care at Northern Health, inpatient settings at all sites will have full ECG integration to minimise clinical risks.

“Nurses and midwives will be able to perform an ECG and transmit it immediately so it can be interpreted by multiple teams from anywhere inside the hospital or remotely.  This streamlined workflow will remove time-intensive steps that nurses undertake to ensure ECG results get to the right team at the right time for review, resulting in safe and timely care for our patients”, says Vanessa Reid, Chief Nursing Informatics Officer.

“Integrating ECGs into the EMR is a key step to getting this crucial piece of clinical information to the right people in a timely manner and reduces reliance on “informal” means of data transmission such as private messaging applications. I cannot overstate the amount of work done by the team to get this working. I am confident it will play an important role in supporting clinical processes across the entire organisation,” says Dr Sing Tan, Deputy Chief Medical Informatics Officer.

“One ECG reviewed and reported on time can make a big difference in patient care. I’m so grateful we have this technology, and I hope this work supports our frontline clinicians in providing the best possible care for our patients,” Nader concludes. ​

Participants attending the ECG validation session. 

Featured image: Nader Elshehabi, EMR Benefits and Clinical Analyst.