Information is the heart of the clinical enterprise. When it comes to cardiac care, immediate access to complete patient information is key to improving both patient care and workflow. But providing that access can be a complex process that hinges on integrating multiple systems. What’s more, integration isn’t the only challenge. “It’s very difficult to find superb imaging and reporting in a single system,” opines Jeffrey Breall, MD, director of cardiac catheterization laboratories and interventional cardiology at Krannert Institute of Cardiology in Indianapolis, Ind. On the flip side, facilities that have taken the plunge into state-of-the-art cardiovascular information systems report significant benefits including:
- immediate access to current and historical images and reports
- simplified, speedy and consistent reporting
- data mining galore to facilitate clinical trials and drug eligibility notification
- the ability to view images and data in multiple locations in near real-time, which facilitates ‘virtual cardiac care’
- reduced costs and improved workflow
This month, Health Imaging & IT visits with a few pioneers to uncover the benefits and challenges of implementing and integrating cardiovascular information systems.
“Deploying a new cardiovascular information system provides a hospital an opportunity to create and build a system based on ideal workflow,” says Lucretia Craig, RN, BSN, director of imaging services at Olathe Medical Center in Olathe, Kansas. Olathe Medical Center has been tackling the IS-driven workflow process since 1997 when it deployed GE Healthcare’s MUSE ECG database.
MUSE is one component of Centricity, the hospital’s fully integrated cardiovascular information system. “MUSE provides online serial ECG access, enabling physicians to pull up previous studies for comparison to immediately note any changes,” explains Craig.
The next step of Olathe’s staggered deployment was to implement Centricity DMS in the echocardiography lab. One of the primary benefits of the data management system is structured reporting. Rather than dictating a report, the physician responds to a few questions in the system to create a report. “Prior to Centricity DMS it might take five days before an echocardiogram was turned around and [the report] available on the patient’s chart. Today, it’s on the chart in an hour or two,” reports Craig. In addition, Centricity eliminates variability in reporting styles. The consistent format makes for easier reading by referring physicians, says Craig.
The Centricity database also streamlines other clinical processes. The medical center can create reports and notify patients as they become eligible for certain drugs or clinical trials. For example, Centricity can pull the names of all female patients under 45 years of age with a certain diagnosis so staff can notify them of drug eligibility. “There’s no more [time-consuming] retrospective chart review,” sums Craig. Olathe Medical Center also deployed Centricity DMS in the nuclear and cath lab departments to provide the same results across the board.
St. Elizabeth’s Regional Medical Center in Lincoln, Neb., improved its cardiology workflow when it deployed McKesson Corp.’s Horizon Cardiology in 2004. On the physician side, the system provides rapid access to images and information, facilitates serial comparisons of studies and enables anytime/anywhere access through MDWeb, says Bruce Couillard, director of cardiovascular imaging.
Physicians, however, aren’t the only staff members to improve workflow and efficiency. The workflow gains extend to the entire cardiology team. Horizon Cardiology streamlines clerical and administrative tasks; paperwork is minimal and the time-consuming, workflow-busting chore of delivering studies is eliminated with autofax/autoprint features, Couillard says.
A final benefit comes on the financial front. St. Elizabeth’s reduced its direct operating expenses by eliminating the need for transcription with Horizon Cardiology’s reporting tools.
The integrated clinical information system
The goal at the Linda and Jack Gill Heart Institute of the University of Kentucky in Lexington is ambitious — an integrated clinical information system. The cardiac cath and electrophysiology labs rely on Witt Biomedical Corp.’s Series IV (which is now owned by Philips) and Philips Medical Systems Xcelera Cath Lab Management. The lab systems will connect into the hospital’s Eclipsys clinical information system.