Gresham Bayne MD
The most common “technology” question coursing through the AAHCP ListServe these days is “What type of EKG machine do you use?” The use of EKG in home care for physicians provides a simple, portable documentation of both the rhythm strip and, if necessary, a full 12-lead EKG. Some devices allow for one-touch visualization of the rhythm strip with memory capture for remote print-out but no 12-lead. Since the rhythm strip is often bundled into any E/M service rendered that date (even if at a different time), and the removal of the transportation fee for EKG lowers reimbursement to about $24 for both technical and professional components, it is important to analyze the purchase of such machines carefully.
The use of an EKG machine in the office setting with the occasional housecall may lead to a different choice of machine than one for housecalls alone. An office setting allows much higher potential volume of testing and places less imphasis on size and weight than the mobile doctor setting. In the mobile setting, additional factors such as print options, battery life, storage capacity, and heated stylus printing methodology become important. I started doing EKGs on housecalls in 1985 and found the only version available then used a 9-volt battery you could buy anywhere (good) and a heated stylus printer to paper which oxidized quickly in the sun (bad).To make the right choice, an EKG machine must ultimately provide a hard printed record and not lose money, so an analysis with certain assumptions can help prevent “buyer’s remorse.”
