Improving the Utility and Sustainability of Novel Health Technology to Improve Clinical Outcomes for Patients: an East Staffordshire Experience of Screening for aTrial Fibrillation with the AliveCor KardiaMobile

Abstract

Atrial fibrsillation (AF) is the most common sustained arrythmia in the world.+1With a two-fold increased risk of mortality, a near five-fold increased risk of stroke, and a two- to three-fold increased risk of heart failure, the rising prevalence of AF is a major public health burden.2Patients typically present with palpitations, chest pain, or breathlessness; however, up to a third of patients are asymptomatic. Identifying this subgroup and commencing them on anticoagulation therapy if justified is therefore a major obstacle and necessity in the secondary prevention of AF.3,4The use of novel health technology in this regard is an option with much potential. Across East Staffordshire Clinical Commissioning Group (CCG), we embraced this potential and piloted an initiative to improve identification of patients with AF by distributing single-lead electrocardiogram (ECG) devices to 18 general practices between October 2019 and March 2020, following an initial workshop as part of a CCG Local Incentive Scheme. Screening data, as well as clinical feedback in the form of a questionnaire using the online platform Google forms, were then collected from the practices. Further, quality and outcomes framework (QOF) data from NHS Digital and Public Heath England were analysed for trends in the CCG and region.5,6We present five insights from our experiences and highlight how single lead ECG devices were used to improve clinical outcomes for patients across East Staffordshire.