As the U.S. population gets increasingly older (the number of Americans over 65 is expected to increase a little more than 12 percent now to almost 20 percent by 2030), the demands on the nation’s health system—particularly in the area of cardiology—will continue to multiply. Cardiology departments and facilities are looking for ways to keep up with those demands, but in an environment in which adding resources is problematic—and expensive. With the use of cardiovascular information systems (CVIS), these facilities are looking to achieve greater financial and staff efficiencies and gain a positive return on their investment, all the while improving the quality of patient care.
When the Western Maryland Health System decided to take its two primary hospitals—Braddock Hospital and Memorial Hospital and Medical Center of Cumberland—and combine their services in one new, modern facility, the time seemed propitious for the deployment of a new cardiovascular digital archiving and data reporting system.
According to Karen Stair, director of cardiovascular services at WMHS, the topic had actually been under discussion for several years since each facility, neither of which used these systems, struggled with serious data management and storage challenges. So, with a team made up of representatives from the cath lab and non-invasive cardiology unit, as well as IT personnel, WMHS started to sound out vendors about their cardiovascular information systems.
Several factors were involved in vendor selection, one of which was the issue of the new system’s compatibility with a pre-existing information system. The old system is used for internal documentation, orders and registration, says Stair.
“The system that we purchased had to be compatible [with the existing system] in order to meet our record storage requirements,” Stair says. WMIS went with Agfa’s Impax Cardiovascular, which was first installed in both hospitals to let physicians familiarize themselves with the system before the new 275-bed Western Maryland Regional Medical Center opened in November.
The results have been impressive, says Ken Hamilton, operations specialist in the interventional cath lab. “We’ve been able to do away with having to store CDs and tapes from our echos,” he says. “We’ve been able to go paperless with our EKG tracings, physicians are able to access studies from home so it has increased the speed of the interpretation of studies, and its decreased door-to-balloon times because the EKG is downloaded into the system right from the emergency room.” Hamilton also notes that digital reporting in echocardiography has improved departmental efficiency and reduced transcription costs.
For the longest time, the Heart & Vascular Center in the Cape Fear Valley Health System in Fayetteville, N.C., had clinical departments that just couldn’t talk to each other. “Our facility functioned in silos,” says System Coordinator Emily Thorne, so that, for example, the echo and cardiac cath labs had their own image and data management systems. Integration of those systems through the implementation of syngo Dynamics and the Sensis hemodynamic recording system, both Siemens Healthcare products, was a breakthrough regarding efficiency.
The biggest change was found in the cath lab, according to Thorne, where a paper-based data-management system, along with chronic cases of procrastination among physicians, had created a situation in which reports that were supposed to be dictated within 24 hours were taking days, and even weeks, to be completed. “Today, 95 percent of our physicians get their reports done within that 24-hour timeline,” she says.
For Derek Woods, manager, cardiovascular and diagnostic neurology information systems at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., the concept of cardiac data management has been in place for quite a while, since 1992 to be exact, he says.
Even so, a switch in vendors to Lumedx was technically challenging, particularly, Woods says, the process of transferring data from one system to another while trying to deal with a vendor “that was on the way out.”
“It was not a painless process,” he says. “But it was one that reaped a lot of rewards going forward.”
These rewards could range from the front end of patient management more closely tracking data like capturing comorbidities accurately in a patient’s medical history or, at the back end—after a procedure has been completed or a