title: Technician run open access exercise electrocardiography.
abstract: OBJECTIVE
  To evaluate the safety, efficacy, and feasibility of the technician run open access exercise electrocardiography service at Freeman Hospital.
  
  
  METHODS
  Questionnaire analysis of the responses of the general practitioners of randomly selected patients who used the service.
  
  
  METHODS
  A tertiary care cardiac centre, providing an open access service to general practitioners in the community.
  
  
  METHODS
  269 patients randomly selected from 552 who underwent open access exercise electrocardiography over a 2.5 year period.
  
  
  METHODS
  Utilisation of service: the reasons for referral, whether the service was optimally used by the general practitioners, and its effect on their management practice; effect on number of cardiology referrals; benefit to the patients; safety, efficacy, and feasibility of a technician run service; general practitioners' assessment of the service.
  
  
  RESULTS
  147 of 178 general practitioners (82.6%) responded to the questionnaire, on 247 of 269 patients (91. 8%). General practitioners used the service for diagnosing ischaemic heart disease in 72.5% of cases, for prognostic purposes in 17.8%, or both in 5.3%. In 197 cases (79.8%), the general practitioners felt that the service had changed the way they managed their patients. The exercise test was positive in 90 patients (36.5%) and identified 38 as at high risk. The service was effective in optimising the cardiology service by reducing referrals by 47%.
  
  
  CONCLUSIONS
  The service was used by general practitioners primarily for diagnosing ischaemic heart disease and not so often for prognosis. The utilisation of the service was optimal as assessed by the high positivity rate. The service meets its primary objective of assisting general practitioners in the management of patients with suspected ischaemic heart disease, and may have helped to optimise resources by reducing the number of referrals to cardiologists. It has helped prioritize patient management and may have benefited high risk patients by facilitating rapid identification and referral. It can be run safely and effectively by trained technicians.
authors.affiliation: Department of Cardiology, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: S
authors.initials: S
authors.lastname: Agrawal
authors.forename: S S
authors.initials: SS
authors.lastname: Danbauchi
authors.forename: J
authors.initials: J
authors.lastname: Goodfellow
authors.forename: S A
authors.initials: SA
authors.lastname: Robson
authors.forename: D S
authors.initials: DS
authors.lastname: Reid
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel; D016507:Cardiology Service, Hospital / Q000458:organization & administration*; D004562:Electrocardiography; D004739:England; D005080:Exercise Test; D005194:Family Practice / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D012017:Referral and Consultation / Q000458:organization & administration; D017678:Sex Distribution; D011795:Surveys and Questionnaires