Cardiac testing in the community
Implementing rapid testing of cardiac and thromboembolic markers enables the streamlining of referrals from primary care to hospital and a faster diagnosis for patients.
Typically a patient suspected of having a DVT or heart failure will be referred to hospital for a scan and specialist assessment. Evidence shows that approximately 50 per cent of these patients are not experiencing a DVT or heart failure. A simple blood test can be performed to rule out the diagnosis thereby avoiding unnecessary referrals.
Furthermore, the diagnostic algorithms from the SIGN and NICE guidelines recommend that D-dimer and NT-proBNP testing should be carried out for DVT and heart failure respectively.
Using the cobas h 232 D-dimer and NT-proBNP tests in primary care enables the healthcare professional, in many cases, to rule out the risk of DVT and heart failure. This helps to reduce unnecessary referrals and results in significant cost saving and a shorter time to diagnosis.
Existing UK sites have already shown positive implementation of this technology into their daily practice.
The Solihull Healthcare and Walk-In Centre accrued a saving of £220,000 in just 11 months by providing a DVT service to a GP registered population of 220,0001.
North East London Foundation Trust which provides a DVT service based at Brentwood Community Hospital to a population of 74,000 people in south west Essex saved £60,0002.
And Whaddon Medical Centre in Milton Keynes provides a diagnostic service for both DVT and heart failure and ruled out 58% of the suspected DVT cases and prevented 48% of suspected heart failure patients from going on to have an unnecessary echocardiogram3.
1) Majid Ali and Victoria Young. Shifting DVT Identification into Primary Care. British Journal of Healthcare Management. 2012. 18(4) pp211 – 214
2) Why shifting DVT management into primary care can improve clinical outcomes. Health Service Journal. December 2011.
http://www.hsj.co.uk/resource-centre/best-practice/care-pathway-resources/why-shifting-dvt-management-into-primary-care-can-improve-clinical-outcomes/5037987.article [accessed October 24 2012]
3) Bringing cardiology testing closer to home. Pulse. June 2012.
http://www.pulsetoday.co.uk/bringing-cardiology-testing-closer-to-home/14137491.article [accessed October 24 2012]