Drowning in Data: Workflow Changes Improve the Collection of Clinically Relevant and Actionable Data.

Abstract

Background: The implantable loop recorder (ILR) is valuable for recording and evaluating clinically relevant arrhythmias. Devices with wireless capabilities are programmed to automatically transmit data to a secure website for retrieval by cardiology staff. However, increased data review time, memory saturation, and overwriting of true arrhythmia episodes can result unless alerts are programmed to appropriately detect meaningful (or actionable) cardiac data. Patients are instructed to manually activate the ILR to initiate simultaneous recording of rhythms as part of routine, scheduled assessments or during symptomatic events. However, patients may feel overwhelmed or intimidated when attempting to generate their own cardiac data because of the large volume of new information and unfamiliar equipment instructions.

Objective: To determine if workflow changes and enhanced patient education improve the collection of more meaningful data from the ILR.

Methods: A retrospective chart review was conducted of rhythm data from patients with implantable Medtronic Reveal Linq cardiac monitors. Cardiac rhythm data were gathered three months before and after workflow changes to compare quality and quantity of remote transmissions.

Results: Significant improvements were noted following workflow changes and enhanced patient education. Scheduled transmissions increased, unscheduled transmissions decreased, and missed transmissions decreased per patient each month.

Conclusion: Workflow changes improved the quality of transmissions and decreased the quantity of transmissions. The capacity to provide high-quality care also improved, as evidenced by the ability to obtain more clinically relevant and actionable data.