PO-03-081 THE AUDIT OF FOCUSONTM SERVICE ACCURACY AND TIME BENEFIT ANALYSIS

Abstract

FocusOnTM (FO) is a service provided by Medtronic Ltd. designed to triage and report cardiac device transmissions in order of clinical urgency using a traffic light system. The benefit of this is improved efficiency of arrhythmia detection as clinically urgent reports are given priority resulting in reduced workload on cardiac centres, particularly within implantable loop recorder (ILR) follow-up. This study aims to assess the efficiency of the FO service and the clinical accuracy of FO ILR reports. Two hundred and twenty-seven ILR patients with Medtronic Linq I & II devices were randomly sampled from the clinical centre’s FO database. Four hundred and seventy-one reports were reviewed and rated between zero and two, within the following categories: rate, rhythm, morphology, miscellaneous details and AF description (table 1). Additional data was collected from the time of transmission to FO to dismissal at the clinical centre to assess time efficiency. None of the reports scored zero for incorrect reporting. Sixty-four percent of reports scored one for requiring more detail in at least one of the reporting categories. Pauses, symptoms, false positives and undersensing event classifications made up the majority of this group. Thirty-six percent of reports mostly including AF/AT, tachyarrythmias and bradyarrhythmias scored two, requiring none to minimal improvement (figure 1). The mean time from ILR transmission to FO reporting totalled eight hours and FO reporting to dismissal at the clinical centre was six hours. Totalling an average transmission to clinical action of fourteen hours which is significantly shorter than pre-FO usage which averaged at ninety-one hours. The results suggest FO is a trustworthy reporting service as all abnormalities were appropriately highlighted within the study cohort. It also highlights the specific areas that required minimal improvement. Amendments to the reporting detail could see improved reporting efficiency and a reduction in the demand for secondary review by senior CS. The speed of review was also very impressive further suggesting FO service is efficient in reviewing and escalating transmissions, providing valuable patient benefits. Future research into this area could see that non-clinical staff at clinical centres are utilised to assist with the workflow.