Use a Checklist to Audit Arrhythmia Documentation

Medical audits are structured evaluations of all aspects of healthcare facilities. This evaluation process must encompass every process leading to billing a claim and all demographic data must match with patient records.

Make sure the chain of custody and data protection are respected when ordering hard copies or digital files, and consider using an evidence tracking software tool as part of your evidence gathering efforts.

1. Review the Workpapers

A checklist is an efficient tool for recording and documenting actions, requirements or events. Generally straightforward to use in different circumstances, its main benefit lies in making sure tasks are completed accurately while also decreasing error risk and improving quality.

Here is an example of a checklist for documenting an arrhythmia detector system’s beat detection algorithm. This list should include features extraction/clustering/template matching or both techniques as part of its beat-detection algorithm, overarching detection scheme, sensitivity and specificity measurements, testing procedures/databases of tapes if applicable and any alarm conditions from either physiological or technical perspectives and user interface design considerations. Need help with English editing, figure illustration or manuscript formatting services? Wiley Editing Services are here! We specialize in English editing/clustering/clustering/clustering/template matching methodologies as well as overarching detection schemes/detection schemes/sensitivity/specificity measurements/sensoria measurements/monitored signals/sensor data/graphemica measurements/graphica’s/thematronic/text conversion processes as well as any relevant procedures/databases of tapes. We offer services with editing English editing/figure illustration/manuscript formatting services! Wiley Editing Services offers expert English editing/figure illustration/manuscript formatting! Wiley Editing Services offers expert English editing/figure illustration/manuscript formatting/manuscript formatting/manuscript formatting/manuscript formatting services! Wiley Editing Services offers English/manuscript formatting support! Wiley Editing Services offers all three! If you require English editing/figureillustrating/manuscript formatting solutions! Wiley Editing Services to assist! If needed help when English editing services, figure illustration services along with figure illustration/manu

2. Review the Documentation

Documentation for devices designed to detect arrhythmias should include basic system accuracy information such as beat-detection algorithm, noise detection/filtering techniques, computerized ST segment capability, programmability and any overall detection scheme employed (e.g. feature extraction/clustering or template matching or both methods), as well as any additional testing necessary beyond what is prescribed in ANSI/AAMI EC 57:1998, Testing and Reporting Performance Results for Cardiac Rhythm and ST Segment Measurement Algorithms.

Making the diagnosis of arrhythmia requires connecting its presence to symptoms experienced by a patient. Ambulatory monitoring provides an unparalleled opportunity to do just this, increasing chances that treatment is provided effectively as well as following up in emergency departments for better patient monitoring – and potentially decreasing risks such as sudden death.

3. Review the Electronic Records

An effective way of diagnosing arrhythmias is linking them to patient symptoms through some form of ambulatory monitoring, and documenting them accordingly. Doing this also allows doctors to ascertain probable causes and conduct risk analyses on whether to refer a patient for electrophysiology studies that seek to elicit sustained arrhythmias.

Once an arrhythmia is detected on a clinical event monitor, its tracing should be sent immediately to the patient so they may review and act upon it. As per Government guidelines, this copy belongs solely to them; so please keep it safe!

Documentation provided by manufacturers should detail any arrhythmia detection algorithm, if applicable (i.e., feature extraction/clustering and template matching methods). If the device’s ST segment capability evaluation uses different criteria than that outlined in ANSI/AAMI EC 57:1998, testing must also be described and its results recorded accordingly.

4. Review the Electronic Medical Records

First step in diagnosing arrhythmias is gathering an extensive medical history from the patient. This should include their full family medical history of cardiac issues as well as any previous episodes that included time of onset and symptoms like loss of consciousness or breathlessness.

An ECG should also be conducted, which in most instances will reveal evidence of structural heart disease which has been associated with arrhythmias. If none are evident, a risk evaluation may still be necessary, even without identifiable structural causes.

An agreed standard should be set for each criterion and this should be supported with evidence from either current literature or clinical guidelines (although in practice these standards may not exist). Once data have been collected and presented in an easily understood format, comments can then be made on how these findings compare with the standard that has been set.