Managing cardiac images offers challenges secondary to the wide array of forms that those images can take. Cardiac catheterization labs produce dynamic images that require storage as cine loops and static screen captures. Ultrasound involves the same configurations, but until recently most of those images were stored as video images and must be converted to digital images from older machines. And 64-slice CT offers amazing cardiac images that pose a serious challenge to manage in terms of volume and quantity.
Cardiac image managment solution approaches vary from institution to institution. Some centers use separate PACS to manage cardiac and radiologic images. Some hospitals have merged images produced in both departments onto a single PACS, and of course, others are in transition.
Across the board, cardiologists appreciate the ability to review images from a variety of imaging modalities on a single workstation. Health Imaging & IT spoke with three facilities about the solutions they have deployed to maximize the benefits and address challenges inherent in managing cardiac images.
Huntsville Hospital, (Huntsville, Ala.)
As one of the largest locally owned not-for-profit hospitals in the nation that includes 881 licensed acute-care beds and serves as a teaching facility for the University of Alabama-Birmingham's School of Medicine, Huntsville Hospital offers a regional referral center with a strong emphasis on the care of patients with cardiac problems. They perform 6,000 cardiac imaging procedures each year.
The answer to their cardiac image management issue was ScImage Picom Enterprise cardiac suite that offers a variety of tools for diagnostic and clinical viewing as well as advanced reporting capabilities that are available through web-based viewing when desired, says Frank Cantrell, administrative manager for cardiology services. Currently, the PACS resides as a separate cardiology component, with another PACS for radiology. They have reading stations installed in the cath, echo, and vascular labs to maximize efficiency.
"In our hospital, the physician who is doing stress tests is also the echocardiogram reader for the day. So he can read echos while he is doing a stress test and doesn't have to go to another department to read," says Cantrell.
With a goal of providing cardiologists with "one-stop shopping" so as they can see everything at one time, this system offers the capability of side-by-side static and dynamic image data set visualization on a single workstation. "So physicians can pull up a nuclear study on one side that may just have a screen capture of the processed images, and on the other side, they can have the echoÖor a catheterization film running," he continues.
The department's previous image management solution included several different systems that they had outgrown, says Huntsville's Manager of the Cath Lab and Electrophysiology Labs Patricia Bailey, RN, BSN. In February, they consolidated image management, going live with the cardiology PACS. They currently have two reading stations in the cardiology area that are not directly inside the cath lab as well as the monitors within the procedure room, says Imaging Engineer Jim Gallardy. This means that cardiologists or surgeons can pull up prior imaging studies or even monitor a case in progress from outside the room.
The cath lab went digital in 1997, and when it came time to install the cardiology image management suite; their modalities produced DICOM3 signals. ScImage was the only company they reviewed that agreed to accept that signal, and that fact saved them between $40,000 and $50,000.
Gallardy and Bailey note that ScImage staff have been extremely responsive to any problems they encounter. "One of the things I truly enjoy about ScImage is that they will help you solve a problem even when it is not necessarily their issue," Gallardy says.
Some of their physicians requested a customized template for reporting, and ScImage staff reengineered the system to permit an individual version that follows that specific cardiologist no matter which reading station is used.
Huntsville continues to build on system capabilities. Bailey relates a work in progress that will enable them to pull in cases from other physician offices, since they function as a major referral center for northern Alabama. They receive few films these days from outlying hospitals, with CDs the media of choice. However, since they are busier than any cath lab in the state of