Evaluating the Process of Ambulatory Electrocardiographic Monitor Application and Completion Rates

Abstract

Abstract Outpatient ambulatory electrocardiographic monitoring (AEM) is often used by practitioners to diagnose an arrhythmia. AEM devices can be mailed to the patient’s home or applied in the office setting. A common barrier that decreases the diagnostic utility is failure to successfully complete the monitoring. Objective: The purpose of this study is to compare the AEM completion rates between patients who self-apply the monitor at home and those who have the monitor applied in the office by clinical staff. Methods: A cross-sectional retrospective chart review was used. The electronic health records were reviewed for billable codes before and after April 2018 when a new office policy of mailing monitors to patients was implemented. A random sample of 50 patients was obtained from each timeframe. Results: The sample included the electronic medical records of adult patients (n=100) seen in the Cardiology clinic. Over half 63 (63%) were female, and the majority 88 (88%) were Caucasian, with 10 (10%) Black or African American, and 1 (1%) reporting Asian race. The average age was 59 (range 20-100). Most patients 98 (98%) had health insurance. The office application group had a significantly higher rate of successful completion 62 (62%) compared to the mail group 38 (38%). The average number of days that the AEM was worn was 18 days (range 7-30 days). Conclusion: The results of this study indicate that professional support and application of AEM in the clinic setting may lead to an increase in completion rates.