Survey of computer-assisted electrocardiography in the United States

The purpose of this study was to update a 1976 study by Arthur D. Little, Inc., on the use of automatic ECG analysis systems. Thirteen vendors of computerized ECG systems received survey forms in 1987 and a follow-up telephone survey was completed in early 1988. The vendors surveyed included service bureaus and providers of computer-based data management and analysis systems and analysis carts. Analysis carts were subdivided into standard-sized and portable analysis carts. The technical specifications used by the respondents varied from 3 simultaneous leads to 14 simultaneous leads. The standards used were AHA, AAMI, and ANSI. Various compression techniques were used. The method of testing adult, pediatric, and serial comparison programs varied from the use of expert electrocardiographers to non-ECG data bases. Service bureau customers consisted mainly of general practitioners and primary care physicians' offices, with an estimated 1.2 million ECGs processed in 1987. Analysis and data management systems mainly serviced large hospitals, with an estimated 15 million ECGs processed in 1987. Standard-sized analysis carts used in hospitals and physicians' offices were estimated to process over 31 million ECGs in 1987. Portable analysis carts installed in hospitals, primary care, and general practitioners' offices and clinics processed almost 7 million ECGs in 1987. Computerized ECG analysis has been one of the most rapidly and widely adopted computer applications in medicine; its potential benefits in improving quality and consistency of interpretations has long been recognized. This study indicates that additional information on accuracy of current ECG software is needed to ensure that the technology is optimally applied in patient care.