The West of England AHSN is working with North Bristol NHS Trust (NBT) to assess the benefits for patients and staff of a cardiac monitoring solution that is seen as a technological advancement from traditional electrocardiogram (ECG) Holter monitoring systems.

The NHS Long Term Plan aims to prevent 150,000 heart attacks, strokes and cases of vascular dementia over the next 10 years. The plan is to do this by improving the detection and treatment of high-risk conditions that increase CVD risk.

Like most hospitals, NBT has a significant waiting list of patients that require ECG monitoring to detect and manage conditions like atrial fibrillation. This is due to many factors, not least relating to COVID-19 related backlogs. In addition, some Trust owned ECG Holter systems can be technologically dated and may deliver poor data quality. Most holters are only able to be worn by patients for 24 to 48 hours and if the arrhythmia does not happen to occur during this time, repeat testing may be required to ensure intermittent arrythmias are not missed.

In April 2021, digital healthcare company iRhythm Technologies Ltd was awarded funding from the NHSX AI in Health and Care Award to trial its Zio XT product across multiple NHS hospital sites, including NBT’s cardiology and stroke services.

Zio XT is an ambulatory ECG monitoring device and service. The technology combines a discrete, wearable biosensor device (which allows for extended monitoring up to 14 days) with cloud-based data analytics drawn from artificial intelligence (AI) algorithms, for faster and more accurate diagnoses of arrythmias. It aims to support the timeliness of diagnostic clinical pathways, improving the likelihood that arrythmias will be detected and diagnosed.

In December 2020, NICE guidance was supportive of the use of Zio XT stating that it was “an option for detecting cardiac arrhythmias but recommended that NHS organisations using it should collect further evidence to resolve the uncertainties”. These uncertainties related to the impact on local service costs and resource requirements, by using of Zio XT.

NBT is therefore keen to review the data they have gathered from implementing Zio XT and approached the West of England AHSN, seeking support to assess the impacts of their use of Zio XT over the past 12 months.

The West of England AHSN is now working with NBT on a ‘proof of value’ project. The project focuses on supporting pathway transformation and a retrospective analysis of Trust and company data. This is to better understand impacts, and support decision making regarding future commissioning of products and services of this type, within NBT’s cardiology pathway.

It is hoped that an innovation such as this could help to reduce delays to diagnosis, prevent unnecessary journeys to and from hospital, release staff capacity and improve outcomes for patients as a result. The results of this proof of value project are expected in early 2023.

Cardiac Physiology Manager at NBT, Suzanne Hatfield, said: “The support from the West of England AHSN has been invaluable in helping us to establish the value of using a technology of this kind within the Cardiology pathway in the Trust. We are eagerly anticipating the results of the evaluation and hope that they will help us to make a decision about commissioning this type of technology in the future.”

Acting Director of Innovation and Growth, Alex Leach said: “The West of England AHSN is very pleased to support North Bristol Trust in exploring the potential value of this new way to support the diagnosis of patients with possible cardiac arrythmias. Technologies such as this offer a huge opportunity to revolutionise the delivery of diagnostic services and we are looking forward to the results of the project to understand the impacts for both patients and the Trust.”

Senior Vice President and GM International at iRhythm, Sandrine Moirez, said: “iRhythm is delighted to be working with West of England AHSN. The evaluation of Zio at Southmead Hospital Bristol will provide further real-world evidence of the value our ECG service provides; helping to inform commissioning decisions and wider adoption of Zio throughout the NHS.”

 Further information

For more information, please email rosie.brown8@nhs.net.

Posted on October 7, 2022

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