Noise is the quietest problem in healthcare | Viewpoint

When we think about “noise” as a problem, the stakes usually stop at annoyance, maybe frustration.

Alan Foreman

When an environment is noisy, we are content to wait for the dog to stop barking, the construction workers to take a break, or the radio static to subside. But what if that acceptance came with a high cost?

Within the healthcare sector, the complacency with electrocardiogram (ECG) signal noise has become all too common. Bluntly, that noise is threatening basic operations and our ability to provide quality care, especially because when the storm of cardiovascular and chronic disease hits, the amount of misclassified data reaching healthcare professionals will only add to the burden—compromising their ability to take correct and timely action.

ECGs form the bedrock of cardiac diagnoses — but whether you’re hooked up to electrodes on your chest or taking a reading from your watch, signal noise is compromising your reading — from sources as varied as powerline interference to your very own muscle contractions. Studies estimate that over 50% of ECGs in remote monitoring systems are affected by noise.

If we heard dogs barking for half of our waking hours, our acceptance levels might change. But to date, this has not been the case in healthcare. Healthcare professionals have to sift through the noise to interpret ECG correctly. At best, this sifting process slows them down; at worst, the noise creates inaccurate interpretations that directly affect patients. One in three ECG interpretations contains a major error, and up to 11 percent of these errors lead to inaccurate medical advice or patient mismanagement.

Patients commonly fear that they get different levels of care based on the luck of the draw when it comes to healthcare professionals, and in the case of signal noise, that fear is warranted.

A study showed that ECG interpretation accuracy can fluctuate between 49 percent and 92 percent based on the healthcare professional’s training and experience level. While it is normal for someone to become better at their job over time, there is another way to immediately raise the standard of care, across the board, no matter who is involved in interpretation: remove the noise issue altogether.

Beyond patient care, the slow-down required to interpret noisy signals demands our attention. In an industry plagued by staffing shortages, widespread burnout, and increasingly thin margins, we owe it to healthcare professionals and leaders to get smarter about time management.

We estimate that a clinician reviewing 50 ECG events per day, with an average two-minute review time per event, could save up to 10 minutes a day if they could focus only on reviewing clean, actionable ECG data. Those 10 minutes could be used to take a breather. They could be used to spend more one-on-one time with a patient. They could even be used to review five more ECG events, cutting back on wait times for patients with time-sensitive conditions. This doesn’t account for the burden of non-actionable ECG alerts generated by noisy signals, which significantly increases alarm fatigue among clinical teams.

When we consider ECG readings and cardiac diagnoses, we are not talking about a sliver of the healthcare system. Heart disease has been the leading cause of death in the United States for over 100 years. Meanwhile, the problem is only growing. Increased prevalence of cardiovascular disease among younger populations, more complex cardiovascular cases arising from COVID-19, and even climate change are increasing pressure on the healthcare sector to diagnose and treat more and more cardiovascular patients.

The challenge extends beyond the clinical setting. Individuals are becoming more attuned to their own heart health as more and more consumers rely on wearables to monitor their own ECGs or report their own findings to their clinicians. It is more important than ever that, wherever ECG readings are coming from—your wrist after a run, your hospital bed after an alarming incident—they are clean, accurate, and guide you and your clinician down the right path.

Signal noise is one of the quietest problems in healthcare, and one that we can’t allow to stay silent any longer. The good news is, we don’t have to wait for tomorrow’s solutions. The right digital denoising algorithms can clean up ECG signals to increase the accuracy and efficiency of interpretation.

Patients and healthcare professionals alike deserve a little peace and quiet when it comes to ECG signals.

Alan Foreman is the CEO of B-Secur.