Impact of Electrocardiography Device Integration into a Hospital Information System on Paper Use, Cost, and Data Accessibility
Sinem Cece1
, İlker Köse2, Özge Elmas3, Abuzer Pınar4, Tuğba Şahin5, Beril Şevval Develioğlu6
1Department of Management Information Systems, Ankara Medipol University Faculty of Economics, Administrative and Social Sciences, Ankara, Türkiye
2Department of Computer Engineering, İstanbul Ticaret University Faculty of Engineering, İstanbul, Türkiye
3Alanya University, Alanya, Türkiye,
4Department of International Trade and Finance, Administrative and Social Sciences, Ankara Medipol UniversityFaculty of Economics, Ankara, Türkiye
5Bahçelievler Public Hospital, İstanbul, Türkiye
6Department of Industrial Engineering, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
Keywords: Data accessibility; electrocardiography; health care costs; health informatics; hospital information systems; workflow efficiency.
Abstract
Objective: This study aimed to evaluate the impact of integrating electrocardiography (ECG) devices into a hospital information system (HIS) on paper use, cost outcomes, and data accessibility in outpatient clinical settings.
Methods: This retrospective observational study was conducted using outpatient data collected between 2017 and 2025. The pre-integration period (2017) was compared with the post-integration period (2018–2025). Outpatient visit volumes, total ECG examinations, repeat ECG rates, paper consumption, and associated costs were analyzed. ECG devices were integrated into the HIS via an HL7-based interface, enabling data transfer to the Picture Archiving and Communication System (PACS) and national health platforms. Data were analyzed using descriptive statistical methods and presented as counts and percentages.
Results: In 2017, a total of 661,329 outpatient visits and 43,548 ECG examinations were recorded, with a repeat ECG rate of 20%. Following integration, ECG data became digitally accessible through the HIS and PACS. Paper-based processes were completely eliminated, resulting in the avoidance of paper-related costs in subsequent years. During the early post-integration period (2018–2021), repeat ECG rates ranged between 19% and 21%, whereas in the later period (2022–2025), they declined to a range of 9.9–11.2%.
Conclusion: Integration of ECG devices into the HIS eliminates paper-based processes, reduces operational costs, and enhances data accessibility for both healthcare professionals and patients. However, digital integration alone may not be sufficient to reduce repeat testing. These findings highlight the importance of integrated digital systems in improving efficiency and accessibility in healthcare delivery.
Cite This Article: Cece S, Köse İ, Elmas Ö, Pınar A, Şahin T, Develioğlu BŞ. Impact of Electrocardiography Device Integration into a Hospital Information System on Paper Use,Cost, and Data Accessibility. Koşuyolu Heart J 2026;29(2):128–135