HCMC NETWORK FEATURE: ECG blog travels around the world

Dr. Smith’s ECG blog teaches clinicians in over 170 countries around the world

Dr. Steve Smith, faculty physician in the HCMC Emergency Department (ED) has specialized in emergency cardiac care and electrocardiogram (ECG) interpretation since the 1990’s.  After writing a book on the ECG in acute myocardial infarction (MI), and writing and editing several other book chapters and textbooks, he grew frustrated by copyright issues, books going out of print, and space limitations on numbers of ECG’s, particularly in cases in which multiple serial ECG’s were necessary to illustrate case progression.

Dr. Smith also recognized that today’s residents seek information from the Internet, not from textbooks, because texts are not interactive, lack video, are expensive, rapidly become outdated, and cannot be edited in real time.  He started sending out an “ECG of the Week” by email to ED residents and then, in November 2008, with the help of Dr.  Scott Joing, another ED faculty physician, he created Dr. Smith’s ECG Blog.  Dr. Joing, along with Dr. Rob Reardon, had created an educational website for the ED, called hqmeded.com (see previous HCMC NETWORK FEATURE), as a place to share high quality educational materials, free-of-charge, so it was an ideal site to which the blog could be linked.

Advantages of Dr. Smith’s ECG Blog quickly became apparent.  Residents found it easy to access the blog from smartphones or the Internet, and its focus on management of subtle, difficult cases addressed a previously un-met need for web-based advanced ECG instruction.  Two posts per month in 2008 increased to 4 posts per month in 2010, and by December 2010, Dr. Smith’s ECG blog ranked #6 on EMCrit’s “Dirty Dozen” best emergency medicine websites.

As favorable reviews and links to the ECG blog were added to other websites, viewership rose.  As of November 2011, the blog has had more than 100,000 visitors from 173 countries, and nearly 460,000 pageviews, with a peak of nearly 2900 pageviews in a single day, 378 followers and 578 Facebook “likes.”   Scott Weingart of EMCrit Blog calls it “a PhD in EKG”.   Video demonstrations and embedded cardiac ultrasound video have been added to further illustrate the ECG.  Posting is up to approximately 8 cases per month, for a total of 178 posts on the site.  Most cases have multiple ECG’s, some with as many as 8 to fully illustrate a patient’s clinical course.  Posts have “labels” (tags), now resulting in a 168-item index.

Viewers in 173 countries have visited the blog, from the US, UK and Australia, to Malaysia, Egypt, and rural India. Viewers post comments and questions, from basic to extremely sophisticated levels, enabling rapid feedback, editing of errors, clarification, and discussion of difficult points.  Response to new blog posts is amplified by other viewers who re-post to popular Facebook pages like, “ECG’s & Cardiology” so that within minutes of re-posting, the blog will get up to 200 pageviews per hour for several hours.  The blog also has its own corresponding Facebook page and Twitter feed.

Dr. Smith says he is very pleasantly surprised at how much time people spend looking at old posts and by the growing number of paramedics who follow the blog, because they are now at the forefront of diagnosing ST-elevation MI’s.  He continues to tweak and improve presentation of his material; intrigued by the positive response to videos, he recently posted a survey that indicated a slight preference for viewing video over text.  Now, Dr. Smith’s ECG Blog has become, essentially, a free online interactive textbook with video.  Check it out!

See photos below of the ECG blog (photos 1 and 2) and video filming process (photos 3 and 4) with Dr. Scott Joing in the HCMC ED “filming studio.”

Photo 1 Dr. Smith's ECG Blog home page

Photo 2 Blog page with video

Photo 3 Filming set up for blog videos

Photo 4 Lighting check for filming blog video

What’s coming up on HCMC NETWORK FEATURES?  Dr. Steve Dunlop and International Emergency Medicine.