Surprises

Would it surprise you that:

• when tested non-IM physicians who thought they could read EKGs failed the test approximately 70% of the time?
• that missed MI's off of EKGs are the highest proportion of malpractice cases for Family Practice physcians?
• many physicians don't want to read EKGs taken at their healthcare organization, but feel they must because they don't have adequate resources to get the expert opinion they want?
• that the two top loci across all malpractice cases for healthcare organizations are history (80%) and EKGs (68%)? The next two loci did not add up to EKGs' percentage?
  
• When tested IM physicians who thought they could read EKGs failed the the test approximately 50% of the time?
• that hospitals and medical centers more that 50 miles from a major population center (SMSA), don't have access to the cardiologists it takes to get the most out of EKGs?
• using the Internet, the expertise of cardiologists in the SMSAs can be harnessed at rates not far above what Medicare pays?

WaveWatch believes that getting the most out of EKGs is an important part of lowering costs in healthcare and improving the care we all give to patients. We also support the physicians who practice away from SMSA's and are keystones to their community's healthcare.

Where do we land all those planes?

The Impact of the ECG Dilemma

If you have visited our site (www.wavewatchgroup.com) you have seen WaveWatch’s focus is solving the ECG Dilemma. Recently our CMO; Paul Mele, MD; wrote in a major journal:

“…Further review revealed that the lowest published error rate in this last, most severe category, is 0.1%, or 100,000 patients in this most severe category (1). To put this number in perspective, a Boeing 747 jumbo jet crashing every other day would not equal this number of people suffering or dying…”

Mele, P. Improving ECG Interpretation in the Clinical Setting. JECG. 2008;41:438-439

Realizing these numbers are the lowest reported error rate, let me break that down a little further based on state population:

· Vermont, one of the smallest state populations, could expect 1 crash biennially;

· Idaho could expect 1 to 2 crashes annually;

· North Carolina could expect 7 Boeing crashes annually; and

· California could expect 27 crashes annually.

But the impact goes beyond this almost tangible result. Many physicians understand they do not have the skills to read the wide range of issues on a modern EKG. If this physician is 50 or more miles outside of a major metropolitan area, access to cardiologists is limited. So the physician must either bear the liability alone (#1 malpractice issue for non-IM physicians is a missed MI on an EKG) or not order the EKG to save the community valuable medical resources? At WaveWatch we have heard from physicians at both ends of this spectrum. Given that population age rises the further you get from population centers, the need for ECGs goes up as that same population suffers from a higher rate of heart disease.

We all know that the availability of cardiology drops off quickly after getting 50 miles from a major population area (1M+). We also know people want to be treated as close to home as possible. Many studies have shown that distance from the patient’s community impacts survival rates. This fact is the foundation of the Critical Access Hospital program. So this means that most of these “crashes” are probably taking place out in the less densely populated, underserved areas where personal ties are close and each loss is deeply felt throughout a community.

The Impact of the ECG Dilemma is to set the needs of patients for care close to home in opposition to needs of physicians to provide care to everyone in community over the long-term.

The WaveWatch Group, Inc. provides a simple cost-effect way to resolve the ECG Dilemma. By building a network of electrocardiologists and cardiologists through each state, we make the distance to the expertise the treating physician needs to care for their patient disappear. Each ECG can be interpreted and used without high cost or long response times. Physicians, no matter where they are, can order the ECG they need to treat their patients with confidence that the interpretation of that ECG will be an asset to the treatment of their patient and not a liability to their practice or hospital or office. Access to reliable, accurate, timely interpretations would stop those “crashes”.

So our new dilemma would be, where do we land all those planes?