Feature | September 15, 2010| Dave Fornell

Cardiac PACS Image, Report Integration Boosts Workflow

Many CIIMS integrate with cath lab hemodynamic and reporting systems, such as McKessons Horizon Cardiology.

Over the past five years, two major changes have occurred in cardiovascular information systems (CVIS) and cardiovascular picture archiving and communications systems (PACS). There is a migration from disparate reporting and imaging systems toward a single, unified system. The second trend is easier access to patient information using Web-based and cloud technology.

These combined CVIS/PACS are referred to as cardiovascular image and information systems (CIIMS).

“The real advantage of these systems is the integration of various reports,” said PACS consultant Gary Reed of Integration Resources. “It provides easy access to all these reports on one, single system and from one log-in. It allows for seamless integration between images and these reporting systems. It really improves workflow.”

He added these systems also update information automatically as new data or images are saved, giving a more real-time look at a patient’s condition.

Most CIIMS offer access to imaging and reporting templates for computed tomography (CT), magnetic resonance imaging (MRI), nuclear imaging and cardiac ultrasound. Many systems integrate with cath lab hemodynamic and reporting systems. They generally offer an advanced visualization software package, many times in partnership with a third-party vendor. Electrocardiogram (ECG) reporting systems have been integrated with these systems over the past few years as well.

Wider Access to Data
There is a big trend away from single-hospital, server-based systems toward Web-based servers, or third-party, cloud solutions. These Web-based technologies allow easy access to the integrated information and images from any location. This significantly increases workflow between different doctors who are treating the same patient, or as a patient moves through various hospital departments (such as the emergency room, radiology and the cath lab).

This goes hand-in-hand with the rapid adoption of regional health information organizations (RHIOs), also called health information exchanges (HIEs), to share patient information between multiple hospitals, clinics, doctor’s offices and specialists.

“Hospitals want to be able to disseminate patient information over a large area network,” Reed said. “These cloud systems allow unlimited access to patient data between  unaffiliated hospitals, healthcare systems and physicians to create a cloud-based HIE.”

There are few, true cloud systems, Reed said, but he expects these systems to proliferate and become the standard PACS platform in the next decade. Most of these cloud solutions will be offered through third-party vendors, which Reed believes will eventually phase out the role of individual hospital information technology (IT) departments in maintaining this ever-increasing amount of data. This offering of “software as a service” has already taken hold in the image archiving and advanced visualization markets.

“The trend definitely has been a move toward thin-clients (Web-based) as opposed to thick-client (dedicated workstations) based systems,” said Michael J. Cannavo, president of PACS consulting firm Image Management Consultants LLP.

Thick-client systems offer slightly better performance and there is no shared bandwidth, he explained. However, Web-based systems are becoming more popular, he said, because they are easier to deploy, cost less and do not require dedicated network connections.

Differences in Systems
Reed said not all vendors are at the same level of integration or may not cover all of the cardiac imaging modalities and reporting systems. While some vendors offer a unified, single database, others can weave together several existing databases so all of a patient’s cardiac images and information appears in one place.

Despite the healthcare industry standardizing on DICOM and HL-7 file formats, Cannavo said most data is still stored in proprietary formats and does not address areas such as gray scale presentation states (GSPS) and image annotation overlays. This also does not allow vendors to share data and create vendor-neutral systems.

Meaningful Use
In July, federal regulations were issued to clarify the definition of meaningful use, enabling federal stimulus money and healthcare IT reforms to move forward. However, the regulations only apply to clinical information systems and exclude PACS. All the large vendors are making commitments to their customers that they will provide whatever is needed to meet any new requirements.

“I would not work with any vendor that cannot include that language in the contract,” Reed said.

Cannavo said the meaningful use definition covers Stage I of the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), which is part of the economic stimulus package. It covers general practice electronic medical records (EMRs). Stage II will include meaningful use criteria for specialties, including radiology and cardiology. The meaningful use criteria for these specialties should be effective by 2013.

Related Content

Esaote Group, Ebit, Frost & Sullivan, technology leadership award, Suitestensa CVIS PACS

Image courtesy of Esaote Group

News | Cardiac PACS| November 24, 2015
Frost & Sullivan presented the 2015 European Award for Technology Leadership to Ebit, the Esaote Group’s healthcare...
Calgary Scientific, Mass General Hospital, RadIQ, mobile radiology education tool, RSNA 2015

ResolutionMD image courtesy of Calgary Scientific

Technology | PACS Accessories| November 24, 2015
Calgary Scientific Inc. announced that they will be showcasing a new radiology education tool called RadIQ in Calgary...
Carestream, Vue Motion universal viewer, ECG waveforms, diagnostic reading, FDA clearance

Image courtesy of Carestream Health

Technology | ECG| November 20, 2015
Carestream has obtained U.S. Food and Drug Administration (FDA) clearance for diagnostic reading of electrocardiogram (...
Fujifilm Sonosite, iViz ultrasound, mobile visualization, FDA clearance

Image courtesy of Fujifilm

Technology | Ultrasound Imaging| November 19, 2015
Fujifilm SonoSite Inc. announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for...
Feature | Remote Viewing Systems| November 18, 2015 | Kim Garriott
There is a growing need to exchange and share imaging studies with outside entities.
Philips IntelliSpace PACS, Xcelera cardiology PACS, UCHealth

Image courtesy of Philips Healthcare

News | Cardiac PACS| November 17, 2015
Philips announced its collaboration with UCHealth, an integrated delivery network of five hospitals in Colorado and...
News | Business| November 05, 2015
November 5, 2015 — On Oct.
Sponsored Content | Case Study | Cardiac PACS| November 02, 2015
Adventist Medical Center in Portland, Ore., is known for its new, state-of-the-art Northwest Regional Heart and Vascu
PICOM, Scimage, Cardiac PACS, CVIS

ScImage's PICOM system is an example of a CVIS that unifies the IT needs of several cardiovascular service lines into a single cardiology department reporting and image management system. This includes cardiac imaging, echo, ECG management and cath lab reporting. 

Feature | Cardiac PACS| October 08, 2015 | Dave Fornell
Cardiovascular information systems (CVIS or cardiac PACS) have undergone a transformation over the past few years to
CMS, Stage 3 Meaningful Use final rule, ONC, healthcare IT, electronic health records, EHR
Feature | Information Technology| October 07, 2015
The Centers for Medicare and Medicaid Services (CMS) released the final version of Stage 3 Meaningful Use (MU)...
Overlay Init