POAC will fund for urgent ECG under the following circumstances:
1. Investigation of current/recent chest pain with possibility of acute coronary syndrome (ACS) – low risk of ACS but diagnosis still under consideration. See Acute Chest Pain HealthPathway. https://aucklandregion.healthpathways.org.nz/27916.htm. ECG must be accompanied by troponin testing, and with evidence of rapid follow up of ECG and blood results (re safe management). POAC does not cover if admission inevitable (ie clear ACS needing admission – St John will do ECG) as not preventing admission.
2. Investigation of current palpitations or irregular pulse, when the alternative is that the patient would have to be sent to hospital immediately for ECG.
3. New onset breathlessness and “silent” MI under consideration but not obviously needing admission – would have to be accompanied by troponin.
Not covered by POAC:
1. Non-acute chest pain
2. Chest pain without cardiac features
3. Investigation of possible pulmonary embolism
4. History of palpitations but none currently present and pulse regular
5. Routine work up of any condition