Technician, ECG
Massachusetts General Hospital(MGH)


Job Info


SCOPE OF POSITION

Performs electrocardiograms on patients of all age groups to record variations in heart muscle electrical activity. Transmit electrocardiograms to ECG lab for interpretation, processing and storage. Maintains patient log and record of procedures for diagnostic and statistical purposes. Functions as an ECG technician over 90% of the time.

PRINCIPAL DUTIES AND RESPONSIBILITIES

List of Job Duties

A Proficient in the performance of ECGs

B Maintain a record of all patients who have had ECGs, this includes age as well as referral source.

C Enter all demographic data into ECG machine prior to performing ECG.

D Transmit completed ECGs to the laboratory on a regular basis throughout the day.

E Performs ECGs on patients with and without magnet for pacemaker checks.

F Be sure associated ECG requisition is complete for billing purposes.

G Transcribe and edit ECGs following Cardiac Staff interpretation.

H Answer phone as necessary.

I Check (proof read) ECG reports that have been typed by one of the other lab personnel.

J Prepare completed ECGs for distribution.

K Deliver sorted ECGs in labeled envelopes to the post office.

L Retrieve previous ECGs as requested.

M Fax ECGs and/or reports to patient units or MD office as requested.

Description of Operation

ECG CLINIC

The Clinic Lab is open Monday through Friday from 8:00 a.m. to 4:30 p.m. Patients start arriving at 8:00 a.m. All ambulatory patients requiring an ECG check in on a first come first serve basis for their electro-cardiogram. The patients are expected to have a completed requisition from the doctor requesting the test. Once they check in, the technician asks for some specific information, i.e., name, verify correct spelling, unit number, age/date of birth, height, weight, name/ID number of requesting MD, and reason for ECG. Once this information is obtained and entered into the ECG cart the technician explains the ECG to the patient. Patients are then asked to remove clothes from the waist up and if female - to remove their nylons. In order to perform an adequate ECG the technician needs access to the ankles, wrists and uninhibited access to the chest area for placement of electrodes. When the patient is completely hooked up with the electrodes the required ECG leads are obtained.

ECG's are transmitted electronically to the laboratory as they are performed or at least twice daily. Once before noon and again around 4:00 p.m. If for any reason the requesting physician needs the results immediately a copy of the ECG is printed and given to the patient to take with him/her to their appointment. The ECG is transmitted immediately with the request for the interpretation to be obtained as soon as possible. Patients utilizing this service come from all ambulatory areas of the hospital. Neurology, Oncology, Arthritis, Diabetes, Child Psychiatry, etc., or from any Physician office other than the private Cardiologists.

PROCESSING LAB

ECGs are transmitted electronically to the laboratory at any given time throughout the day. Once they are printed in the ECG lab they must be taken off the printer, separated and matched with the corresponding order (requisition) for the ECG. There are many ECGs transmitted to the laboratory with missing or incorrect information. If a corresponding ECG requisition is not received a call has to be placed requesting the requisition and/ or correct information as the case may be. Sometimes it is not obvious which location the ECG originated from. In the case there is no corresponding requisition the ECG cannot be processed. The lab also receives requisitions for ECGs and no corresponding ECG was transmitted. Again a call has to be placed notifying the unit no ECG has been received. The need for these phone calls is time consuming and disruptive of the flow of the work. It is not possible to process many of these ECGs and this results in a loss of revenue.

Once the ECG's are matched they are placed in a basket in preparation for the scheduled MD to read. This is done 4 to 5 times each Monday through Friday, and twice a day on Saturday and Sunday. The number of ECGs placed in each physician's basket is counted to be sure the MD gets credit for the appropriate number of ECGs they read.

Once the MD interprets the ECGs they are transcribed into the MUSE system by one of the laboratory personnel. Once the ECG is typed it is confirmed and printed. (This step drives the professional side of the billing.) Someone other than the typist checks the typing for accuracy. If any errors are found they are corrected and the ECG is printed again. After the ECGs are checked and found to be accurate they are sorted into locations. Envelopes are prepared for each unit that transmitted ECGs and the envelopes with the ECGs are delivered to the post office for distribution to the patient units. This process is repeated through the day until all the tracings received have been read, checked and distributed to their appropriate location.

Every member of the laboratory staff performs the tasks described above, including the Head Technician and Assistant Head Technician.

Qualifications
QUALIFICATIONS

  • High School graduate plus additional specialized ECG training. Specialized Computer and/or word processor training.
  • A minimum of one year experience as an ECG technician. Knowledge in use of standard electrocardiography equipment.
  • A minimum of one year experience with computer/word processor.
  • Will need 3 to 6 months orientation on the job


  • SKILLS/ABILITIES/COMPETENCIES REQUIRED

  • Attention to detail is extremely important. It is essential patient records are accurate, i.e., correct MGH unit #, DOB, hospital location, correct physician ID number, pertinent diagnostic information, and accuracy of transcription.


  • Mental alertness is equally important. Much of the patient and/or physician information is a sequence of numbers. Interpretation of the ECGs is done by the use of standard medical abbreviations. Needless to say one has to pay careful attention that the numbers are entered in the correct order. Likewise when reading the doctors handwriting it is imperative the correct acronym is entered into the computer. Otherwise the interpretation could be misconstrued.


  • Age specific skills. The ECG laboratories see patients of all ages and consequently the main lab processes tests on all age groups. There are variability's in ECG criteria between pediatric ECGs and adult ECGs. When performing ECGs on a child one must take time and patience with the child, explain the procedure in a way to prevent the child from becoming anxious and reassure the child of the fact the test is painless. Otherwise, it may be impossible to obtain a technically adequate test. Pediatric ECGs are far more time consuming than Adult ECGs. They may take as long as 30 minutes to obtain a technically adequate record.



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