Technology
Implementing digital ECGs at Barts Health
Patients with chest pains and suspected heart attacks are benefitting from better informed decisions in a high-impact initiative led by clinicians, writes Dr. Krishnaraj Sinhji Rathod, a Consultant in Interventional Cardiology at Barts Health NHS Trust. He explains the clinical, environmental, and efficiency significance of digitising electrocardiograms, and the opportunity to scale success more widely in the NHS.
Picture the moment: a patient in an ambulance is enroute to hospital with new chest pain. Paramedics understandably suspect a possible heart attack having carried out an electrocardiogram (ECG). On arrival at the hospital the patient’s prior ECGs are not available, with paper printouts unavailable on the ward, and potentially buried in a paper archive, or not documented in the patient record. Further clarity is needed. Clinicians assess the patient, and they order tests such as a chest x-ray or an angiogram to help diagnose the problem and to identify the best course of action.
A different approach, that has quickly become
mainstream practice at Barts Health NHS Trust, is changing how clinical teams can make better informed decisions in such situations, helping to get patients on the right pathway at the earliest opportunity. Led by Dr. Krishnaraj Sinhji Rathod, Dr. Andrew
Wragg and the Trust’s interventional cardiology team, and supported by the introduction of WiFi enabled Baxter ECG machines, the approach
has been derived from a patient safety driven project that has transformed visibility of ECGs across four of the Trust’s hospitals. Clinical gains, consistently appropriate treatment, and a positive environmental impact are resulting.
The right tests, the right place, the right course of action Digitisation is providing an unprecedented availability of ECG history to clinical teams. It means that within minutes or potentially seconds of arrival, and sometimes even before patients arrive, clinical colleagues can look on the Trust’s clinical record system and examine what previous ECGs looked like. In the scenario described at the beginning of this article, if the patient’s symptoms are not suggestive of a heart attack, despite concerns raised in the new ECG, availability of identical previous ECGs can enable a clearer decision to be made about the right course of action for that patient. This might mean direction to a different
site, or a different type of test rather than an angiogram for example, and we can accelerate
the most appropriate diagnostic and care pathways. It also means that in clinic we can enable faster reviews of ECGs through a flow of information with district general hospitals, something not previously possible with paper records.
Successful adoption When we started this project, less than a third of ECGs were being captured digitally across our sites. Now, some 80% to 90% of ECGs are captured digitally at the Barts Health Centre in St Bartholomew’s Hospital, and by colleagues in Newham, The Royal London and Whipps Cross hospitals. This has been an amazing transformation and it is still growing – with areas such as our intensive care unit and specialist beds on some wards readying to come on board with digital ECGs in the next year. Training has been straightforward, staff have found this quick and easy to use, and our digital process is removing risk of errors. We made new use of the Trust’s WiFi enabled ECG devices – harnessing our existing technology investments in new ways, with Trust engineers and partners at technology provider Baxter, working together to enable information to flow between the devices and our care record system. This has meant that, for staff, the system is simple. Using the Trust’s care record system, the nurse requests the right test, which is then automatically picked up on our ECG machines. The healthcare professional using the
machine, then verifies the patient name and date of birth at the bedside – using data on the machine and matching this to the patient’s wristband, allowing them to make sure data is captured for the right patient. The ECG is then carried out and transferred immediately and directly from the Baxter device, and into the electronic care record system.
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www.clinicalservicesjournal.com I February 2026
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