This case study demonstrates how ECG On-Demand, a company providing digital cardiology diagnostic services, has successfully migrated to improved connectivity by replacing their Transition Network (formerly N3) services with new Health and Social Care Network (HSCN) services.

We also look at how Bradford District Care NHS Foundation Trust are using ECG On-Demand’s applications over HSCN connectivity to improve patient care and response times.

About ECG On-Demand Ltd.

ECG On-Demand Ltd. is a Care Quality Commission registered medical technology company that provides cardiology diagnostic services to NHS trusts and healthcare organisations.

Their UK Based clinical staff includes consultant cardiologists, who help provide the ECG On-Demand service which uses an artificial intelligence system to assist clinical staff with patient ECG analysis to improve reporting times and increase accuracy.

ECG On-Demand previously used N3 to provide the ECG On-Demand service and found that data transfer speeds created bottlenecks and it was difficult to provision extra bandwidth. When they migrated to their new HSCN connections, they reported much higher speeds, increased redundancy (through multiple network paths) and scope for future expansion and lower costs.

Within the ECG On-Demand service, ECG On-Demand primarily offers two solutions; 12-Lead ECG Interpretation and Ambulatory ECG Holter monitoring analysis.

12-Lead ECG Interpretation

12-lead ECG machines record high fidelity digital electrocardiograms (ECGs) from patients and send them securely to ECG On-Demand via HSCN. An expert cardiologist examines the ECG trace using specialist analytical tools (with AI
assistance for accuracy and speed) and returns the results to the clinician as a digital report attached to the patient’s electronic record.

The ECG report consists of simple risk rating, detailed technical analysis and details of the cardiologist who examined the ECG trace for additional patient management advice.

Ambulatory ECG Holter Monitoring

ECG On-Demand provides patients with a waterproof, rechargeable, wearable Holter monitor which continuously records a patient’s cardiac activity between 24 hours and 21 days.

The data recorded by the ECG monitor is uploaded by the patient’s healthcare organisation and transferred to ECG On-Demand where it is analysed by a member of clinical staff using an AI-assisted ECG analysis system. A ECG On-Demand cardiac physiologist generates a detailed report of their findings within two hours of data upload.

Some healthcare organisations – such as Bradford District Care Foundation Trust, have reported an average reduction in time to diagnosis from several weeks to a couple of days. The life-threatening nature of some of the diagnosed cardiac disorders means a significant improvement in the quality of life and better outcomes of care.

Bradford District Care Foundation Trust

Bradford District Care Foundation Trust (BDCT), a mental health provider, have completed their migration to HSCN and use ECG On-Demand’s ECG On-Demand platform in hospital, community and home settings. They perform ECGs for antipsychotic drug monitoring and physical health checks.

The trust previously used paper-based ECG machines and the ward doctor would interpret the generated ECG trace and manually input its data into the system. Depending upon the clinical need, the trace would then be posted to an acute care provider for analysis before results were returned to the BDCT. This process could take up to two weeks and could delay patient care.

With the ECG On-Demand HSCN-connected 12-Lead ECG machines, the trust has experienced a faster process. Average turnaround times of 15 minutes from the clinician’s initial upload of a 12-lead ECG and 2 hours for a Holter report to be returned securely have been achieved. The purely digital process eliminates the need to use paper and frees up hospital’s clinician resources, allowing more time to attend to patient needs.

Much shorter waiting times have significantly improved patient care as more serious cardiac conditions can be diagnosed earlier. As the ECG is examined and reported by an experienced clinician in near real time for serious ailments, patients are also not required to be transferred between various settings for confirmatory diagnoses. This is particularly significant for BDCT patients, as mental health patients are often reluctant to attend conventional healthcare settings and as a result, have a shorter life expectancy than that of the general population. BDCT now have the ability to perform medical checks on their patients in familiar environments helping to
address this inequality in life expectancy.

HSCN and ECG On-Demand have also enabled Bradford District Care Trust to think more broadly and widely about obtaining a variety of clinical diagnostic technologies to ensure that they cater for every patient need.

“Given the medications our patients need to take, and their general poor health, we know ECG testing is important but we don’t have the expertise to read them. Since the adoption of HSCN & ECG On-Demand technology, it is now much easier and faster to get an ECG report and take the required action.

As a clinician, you don’t necessarily get involved in [tech] – but this is simple.”

Fiona Cooke, Physical Health Lead,
Bradford District Care Foundation Trust


Increased Bandwidth

Migration to HSCN has increased ECG On-Demand’s bandwidth and connection speed significantly (50Mbps to 200Mbps). This allows for faster file exchanges, important for end-users as the ECG On-Demand service requires a large amount of file exchange to function, as files from ECG patches can be up to 100MB per 7 days use. Since the move to HSCN, ECG On-Demand have reported a decrease in Holter monitor upload times from 4 minutes to less than 60 seconds. ECG On-Demand also continually monitors network usage and can contact their network provider, to increase the bandwidth as and when needed.

Real time responses

The increased speed of file exchange in the 12-Lead ECG interpretation process allows ECG On-Demand’s clinical team to report on patients’ ECG traces in near real-time. Therefore, high risk or suspected serious cases can be identified more promptly. This makes patient care safer as it ensures that they are treated efficiently by the appropriate clinicians in the appropriate care settings.

Greater accessibility

HSCN and its ability to be deployed rapidly in locations that were previously only subject to slower N3 connectivity (which was not suitable for Holter uploads), has given NHS users the ability to provide clinical diagnostic services to hard-to-reach patients. Examples include those in nursing homes, mental health units or prisons via portable and fully mobile ECG recording solutions. This benefits these patients as they may have a number of other health, social and/or mobility issues and having the ability to use these mobile solutions reduces their need to travel to the hospital.