Simple workflow improvements — and technology designed to help reduce unnecessary repeats — may save time, resources and patient frustration.
Electrocardiograms are among the most frequently performed diagnostic tests in primary care, but they are also repeated far more often than many realize. In a Baxter (formerly Hillrom) study with 101 respondents, the prevalence of repeat ECGs in the primary-care setting is approximately 11%.1
In many clinics, issues such as artifact, poor data quality, or improper lead placement result in ECGs being redone before the physician even reviews them. Baxter’s study found that physicians encountered poor-quality or artifact-laden ECGs about 19% of the time, and more than half of those problematic tracings required a repeat.1 In addition, roughly a quarter of end-users chose to repeat the ECG before submitting it, often out of concern that the initial tracing would not be usable.1
These repeat exams may seem like an acceptable inconvenience, but they collectively create meaningful clinical and operational burdens. Every repeated ECG consumes staff time, equipment availability, and appointment minutes that could otherwise serve other patients. They can delay diagnostic decision-making, particularly when the ECG is needed to evaluate arrhythmias, ischemia, or other time-sensitive conditions. Patients may also become frustrated when asked to wait longer or return for another test. At scale, repeat ECGs contribute to workflow inefficiencies and can undermine both productivity and revenue for primary-care practices.
The causes behind repeat ECGs are typically preventable. Baxter identifies several contributors, including patient movement that introduces motion artifact, degraded or expired electrodes, worn adapter clips or lead wires, and electrical interference from environmental sources.1 In many cases, the issue originates with inconsistent training or infrequent practice, as primary-care staff may not perform ECGs often enough to maintain confidence in lead placement and preparation. Even small missteps – skin not fully prepped, leads placed slightly off-position, or equipment not inspected regularly – can lead to distorted signals that render the tracing unusable.
Why quality matters
Reducing repeat ECGs begins with strengthening the first-pass quality of the exam. High-quality ECG devices equipped with data-quality algorithms can automatically select the cleanest segment of data, minimizing the effect of motion or intermittent interference. Baxter’s portfolio of ELI ECG devices, for example, use extended-data recording that captures multiple seconds of ECG tracings and extracts the best 10-second segment for interpretation.2 Clinics can further reduce repeat exams by reinforcing consistent patient-prep protocols – ensuring clean, dry skin; removing lotions or oils; addressing hair at electrode sites; and maintaining a calm, low-interference environment during the test.
Equally important is standardizing workflow and training. Routine refreshers on lead placement, equipment handling, and troubleshooting common issues help ensure that every staff member has the confidence and skills to obtain a high-quality tracing on the first attempt. Regular equipment checks – verifying the condition of electrodes, wires, and clips – also may prevent quality issues that accumulate slowly over time.
ECG-to-EMR connectivity plays a role as well. Seamless digital transfer can help reduce uncertainty about whether a test has been completed or documented, preventing unnecessary repeats triggered by missing or misplaced results.
Taken together, improving ECG quality at the point of capture can reduce the number of repeat exams. For busy primary-care practices, addressing this challenge leads to streamlined workflow, improved patient satisfaction, reliable clinical data and a reduction in wasted time and resources. With more than 100 million ECGs performed annually in the U.S., even small gains in quality can have an impact across healthcare settings.1
References:
1 Baxter. Best 10 Research—Repeat ECGs. Clinical Study. Retrieved August, 2022.
2 Baxter Internal Data on File.
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US-FLC64-260001 (v1.0) 01/26
Why ECGs are essential
Early detection of cardiac conditions: ECGs help identify heart rhythm abnormalities (arrhythmias), ischemia, or previous heart attacks, enabling clinicians to detect cardiovascular issues early – often before symptoms become severe.
Guiding treatment decisions: ECG findings inform medication choices, referrals to cardiology, or urgent interventions. In primary care, this allows providers to manage chronic conditions like hypertension or heart disease more safely and effectively.
Baseline and monitoring tool: ECGs provide a baseline for a patient’s heart function, allowing longitudinal comparison over time. Regular ECGs help monitor the effects of medications, disease progression, or post-procedure recovery, supporting proactive rather than reactive care.