Cardiology PACS: Giving Cardiologists the Information They Need...Now

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The saying 'time is of the essence' pertains perfectly to the time-constrained healthcare environment that physicians, nurses and hospital staff deal with on a daily basis - particularly in the realm of cardiac care. Many cardiovascular patients receive initial care in the ER and need immediate intervention. Others have had numerous tests - echocardiography or vascular exams and cardiac cath procedures - and cardiologists need quick access to these images and reports.

With PACS, cardiology departments deliver this pertinent information to caregivers wherever, whenever within seconds. Cumbersome videotapes and hardcopy film are being phased out and replaced with digital imaging and high-speed networks for their transmission. Cardiology PACS are improving workflow, speeding up report turnaround time and allowing more informed decisions to be made at the point of care.

Cardiology is swiftly moving into the age of digital image acquisition, storage and transmission. With the implementation of complex computer networks and PACS, diagnostic cardiology units are replacing videotapes with digital cine loops and cardiac catheterization labs are storing their images to a centralized, electronic data repository immediately after procedures are completed.

The PACS-related workflow benefits cardiology departments experience include:
•    Quicker access to images
•    Rapid transfer of images within and outside the hospital
•    Simultaneous viewing of images at multiple locations
•    Simultaneous viewing of images from various modalities
•    Elimination of misplaced, damaged or missing film or videotape

For cardiologists, interventional cardiologists and vascular surgeons, digital images and patient information are accessible from any workstation that is connected to the system whether it's within the hospital building or at a remote location.    

The cardiology department at NorthEast Medical Center, a 425-bed facility in Concord, N.C., recently implemented Witt Biomedical Corp.'s Calysto for Cardiology PACS. The enterprise-wide cardiology imaging and information management system serves as the hemodynamic system in the cath lab, is used in the electrophysiology lab for patient monitoring, and does image archival and review - as well as report generation - for cath and echocardiography studies.

With the elimination of film, some steps in workflow that are conducive to an analog-based environment have been eliminated. "In a busy [analog-based] lab, it may be 30 minutes to a couple hours before physicians have access to echo and cath lab images and reports," says Richard Strickland, cardiology PACS administrator at NorthEast. "Now, [with the PACS,] our cardiologists can actually come out of the procedure room, sit down at the computer, review the images, make their notes in the electronic record and generate a report immediately."

An interface with Meditech [hospital information system] enables the completed report to be distributed throughout the whole hospital in 15 minutes, as well as emailed out to referring physicians.

In emergency situations, patient information and images are available at the point of care. "Before in an emergency situation, patient information and images had to be pulled from medical records," says Strickland. "If that was in the middle of the night, it could take a while. Now, the medical staff just has to walk over to a computer and type in the patient's name and they have access to everything the patient has had done."

Strickland says physicians agree that workflow in echo is much more rapid in the digital world than having to load individual VCR tapes and fast forward or rewind backward to find something. "[With the PACS], physicians can display up to 32 different loops at a time on a computer screen," says Strickland, "which is much faster for them."

Oscar Munoz, MD, interventional cardiologist at Del Sol Medical Center in El Paso, Texas, exemplifies the benefits of a cardiology PACS using the following clinical scenarios: "We were performing an emergency cardioangiogram on a patient. During the middle of the test, we saw two vessels occluded and the EKG was equivocal. We were not certain which vessel had the new occlusion to intervene. Using the PACS and a workstation in the control room, we referred to the patient's prior cath images and quickly determined which vessel was previously occluded.

"In another situation, a patient had a replacement of an aortic valve," Munoz continues. "Soon after the