Cardiology PACS: Heart at Work

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Cardiology departments are revamping their image capture and management systems with digital technology to combat growing patient volumes and enhance patient safety, efficiency and overall care. Radiology is the leader of the image management pack, but cardiology is gaining stride. More heart-care centers are implementing digital storage and retrieval systems to improve multi-site physician access to images.

Cardiovascular disease is a leading killer of Americans. All totaled, cardiovascular diseases including heart disease and stroke, still outweigh cancer deaths.

It is no surprise then that cardiovascular surgeries and procedures are steadily increasing. From 1979 to 2002, the number of cardiac catheterizations surged 389 percent, according to the American Heart Association; more than 1.4 million inpatient cardiac caths were performed in 2002. The average total charge for patients hospitalized for diagnostic caths increased from $11,232 in 1993 to $16,838 in 2000, according to the Agency for Healthcare Research and Quality. However, the average length of stay decreased from 4.7 days to 3.6 days.

Increased digitization of cardiovascular services may be a contributor. More and more heart-care centers are saying goodbye to film, CD and video - as well as manual workflow - and installing state-of-the-art digital acquisition systems. More recently, healthcare providers are implementing the digital storage and retrieval systems to manage them.

Research firm Frost & Sullivan estimates that cardiology PACS (picture archiving and communications system) sales will rise 20 percent a year, from $160 million in 2004 to $430 million by 2009 - a steady increase, seeing that only 17 percent of cath labs and 8.5 percent of echo labs reported using PACS in 2002.

There are a number of reasons for implementing cardiology image archiving and distribution systems, including:

  • One central, online location for cardiology data.
  • The ability to review multi-modality images on high-speed workstations, or non-diagnostic quality images anywhere, anytime.
  • Simultaneous review of images.
  • Better image quality and diagnostic tools.
  • Faster report turnaround time, out-the-door billing capabilities and increased revenues.

Multi-site access

"Digital imaging and electronic reporting allows HealthFirst to provide patient care in the timeliest manner," says Thomas Donahue, cardiology PACS administrator at HealthFirst in Florida, a consortium of three non-for-profit hospitals: Holmes Regional Medical Center, Cape Canaveral Hospital and Palm Bay Community Hospital. HealthFirst selected Heartlab's Encompass Cardiac Network to manage the enterprise-wide cardiology image and information management needs of the three hospitals.

Health Firsts' three hospitals perform more than 9,000 cardiac cath procedures and 21,000 ultrasound exams annually. Cardiac specialists perform more than 6,000 invasive procedures and more than 700 open heart procedures each year. "Being a multi-site hospital system, communication between IT, cardiology and our vendor is critical," says Donahue. "We move gigabyte studies back and forth between hospitals 20 miles apart. That much data over the network puts a lot of demand on our system. With our built-in resiliency, we don't have to worry about losing patient studies or delaying the doctor's access to images."

With the system, physicians do not have to go down to the cath lab or viewing room once an exam is done. Studies are instantly available for review on any of Heartlab's 21 workstations, located in the different cardiovascular departments of all three hospitals. A web tool enables users outside of the Heartlab system access to images over the organization's secure internet virtual private network (VPN). With Heartlab's results management modules, physicians can create electronic reports while reviewing studies on-line. Once completed, finalized reports can be retrieved instantly by doctors in the OR, ICU or at the patient's bedside.

The web tool allows authorized users access to HealthFirst's cardiology data in doctor's offices and remote locations. HealthFirst used to have a courier deliver its pediatric ultrasound studies to Orlando, which is a 45-minute drive away. Now the internet acts as an instant courier for the images.

Integration of information

Vascular surgeons, interventional cardiologists, diagnostic cardiologists and noninvasive cardiologists at MetroHealth System's Heart and Vascular Center are all accessing online