Defining Cardiology's Clinical Dashboard

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Cardiology image and information systems - also known as cardiovascular information systems -share the ability to provide rich repositories of up-to-the-minute clinical information from physician offices to clinics to inpatient studies and tests, including managing patient images and physiologic data - but vendor to vendor, capabilities differ a bit. Here is a sampling of systems in action at a variety of facilities. And click here for a comprehensive CVIS vendor chart to do some comparing.

A common error comes in comparing cardiology and radiology image and information management systems, but given the different workflow patterns and goals of the two departments, it seems inappropriate to do so. In radiology, the usual end goal involves acquiring images for the radiologist to interpret and use in creating a differential diagnosis, followed by a report to guide the referring physician in designing a treatment plan (with the exception of interventional radiologists).

In cardiology, images as well as a large amount of quantification physiologic data are gathered to assess the overall health and function of the heart. Not only is a differential diagnosis generated, but often the cardiologist serves as the physician managing the next steps in treatment.  Given the dynamic processes dependent on evolving information, cardiology image and information systems must possess innumerable capabilities not necessarily found in a typical PACS or RIS.

A patient, who enters the hospital with chest pain, when the EKG and laboratory studies are positive, proceeds along a diagnostic and treatment path that may take him or her to the cardiac catheterization laboratory for an invasive procedure that could evolve into a treatment intervention. The need for documentation of all parameters of testing requires systems that are extremely powerful and that can correlate data from a wide array of different diagnostic modalities.

Here, presented in alphabetical order by vendor, is a description of the capabilities of cardiology image and information systems manufactured by a variety of industry leaders.

Agfa Heartlab, Agfa's Cardiology Business Unit, offers an enterprise-wide cardiology image and information system that allows physicians and staff to gain access to critical patient information. It is designed to manage physician reports in a single repository while creating a database that integrates relevant patient information into one system. Because staff are able to query and export structured data, Heartlab's system provides physicians with a longitudinal view of clinical patient information to facilitate care and increase operational efficiency.

Alan S. Katz, MD, FACC, director of medical information technology at St. Francis Hospital, The Heart Center in Roslyn, N.Y., is using the Heartlab system in their 270-bed hospital where 80 percent of their caseload involves cardiology. They perform 7,000 cardiac catheterizations, including 4,000 percutaneous coronary interventions (PCIs), each year, as they accomplish fewer procedures in the operating room and more in the cath lab. St. Francis first installed a Heartlab system in their cath lab in 1998, and went live with digital echo two years later. They selected the system because of the speed with which images could be stored and retrieved.  In addition, the system is used to generate reports in the echo labs with both images and reports currently available for review throughout the hospital. At this point, they are working to enable that capability on an extranet in secure access across the internet.

Katz describes great service from Heartlab staff, and says this is a very reliable system as they've experienced few problems. Once when the web access went down, Heartlab replaced the server.

Additionally, he notes, "The ability to interface with multiple different vendors' equipment is important. We have systems from Siemens, Philips and GE. Each has specific capabilities so it is good to be able to have all of them available." The Heartlab system has effectively managed images from each system.

Given the benefits of reading digital images (Katz says he would never want to go back to routine reading of echo studies off of tape), this system has enabled improvements in their ability to manage their complex cardiac patients.

Introduced in 1999, Camtronics Medical Systems' Vericis for Cardiology system serves as an enterprise-wide information management system for multi-modality cardiovascular