The need for improved interoperability between healthcare IT systems and medical devices has been a growing problem in an increasingly integrated medical field. This is especially true in light of U.S. healthcare reform requirements, meaningful use demands and new rules requiring software integrations to receive reimbursements from the Centers for Medicare and Medicaid Services (CMS). Physicians are trained to treat patients, not to deal with IT integration issues, and many ask why they cannot access information they need from the Internet from anywhere, the same way they do on smartphones or their home computers. Until recently, this same level of connectivity has been elusive with their own hospitals’ IT systems. Over the past couple years, vendors have answered this question by launching Web-based software systems enabling anywhere access using encrypted, HIPAA-secure Internet connections.
The trend in Web-based software started in radiology picture archiving and communication systems (PACS), but has expanded to cardiovascular information systems (CVIS — or cardiac PACS). Web-based software has several advantages over traditional thick-client, server-based systems. These include:
• Access to the system from any computer or mobile device with Web access.
• Eliminates the need for hard drives on each computer to have copies of the software, since software exists in a central, Web-accessible server.
• Easier to maintain, since software upgrades are performed on the central server, eliminating the need to load new software on every computer that serves as a cardiology workstation.
• Enables easier external links to data and images outside of a cardiology department, and allows links to the information in a patient’s electronic medical record (EMR), or remote access for referring physicians, external offices or clinics, or health information exchanges with other hospitals.
• Allows physicians to access data, images, waveforms and reports remotely from their workstations for better efficiency.
• Can enable new ways to work, allowing reports to be completed between patient visits or procedures, regardless of where a physician is located. It also enables use of a tablet device in place of a clipboard or need to log into computer terminals during rounds.
• Web-based systems help unify several disparate software systems into a unified CVIS with one login point of entry.
Southern Regional Medical Center (SRMC), a 331-bed, full-service hospital managed by Emory Healthcare, located in Riverdale, Ga., a suburb of Atlanta, implemented Agfa Healthcare’s Impax CV12 in August 2013. They went live with a new Meditech EMR a month later, which incorporated links to information from the new cardiology CVIS. The combination has greatly improved compatibility between these systems. The hospital already used Agfa for its radiology PACS and also wanted to achieve greater compatibility by using Agfa’s cardiac PACS. The system enables the hospital’s cardiology team of more than 80 staff to have real-time access to a patient’s full cardiovascular history.
“For the first time our cardiovascular department can seamlessly consult a patient’s medical history alongside images generated within cardiology and radiology to get a complete, real-time picture of the person’s condition,” said Marcia Frye, director of cardiovascular services, SRMC. “Though less than a year since going live, we are already realizing significant improvements in clinician workflow efficiency, standardized reporting and overall patient care management; all of which we anticipate will translate into a cost savings of $700,000 over the next five years.”
Frye said the system also reduced IT support needed for regular software upgrades. “The benefit of a Web-based system is to make it more available to users, reduce the compatibility issues, and not have to load software on each individual computer,” she said.
It also enables access to the system from anywhere using mobile devices. “The physicians really like the ability to access the system anywhere using a mobile device,” said Melissa Bergmann, cardiac business support analyst, SRMC. “We now have a couple doctors using tablets for most of their duties instead of a workstation.”
Better Referring Physician Access
SRMC refers a lot of cardiac patients to Emory in Atlanta, because the center does not offer coronary artery bypass graft (CABG) surgery. In the past, the center had to send a hard copy of patient records and a CD of their imaging with the patient or by courier. However, with the Web-based system, Frye said this is no longer necessary. Emory can now access imaging and patient data from the Web-based cardiac PACS via remote access.
“It’s definitely better for accessibility,” said Brandi McLean, Web administrator IT, SRMC. “If physicians want to see images offsite, you don’t have to worry about burning CDs. It really helps with sharing images.”
Oklahoma State University Medical Center (OSUMC), located in Tulsa, Okla., used multiple IT systems to store relevant cardiology patient information. Clinicians were required to log on to as many as five different systems in order to review historic patient cardiovascular images and reports. Images were available only in the cardiovascular department. This made it difficult for them to do their work in a timely manner and forced them to have to return to the department any time they needed to review an image. The inaccessibility of images also made it more difficult for physicians to collaborate.
To expand access to data and images and improve workflow, the cardiology department deployed GE Healthcare’s Web-based Centricity Cardio Enterprise CVIS.
Due to its Web-based nature, deployment went smoothly. “We didn’t even require an IT staffer to install the application on physicians’ computers,” said Connie Ryan, clinical resource manager for cardiovascular services, OSUMC. “It saved us a great deal of IT time, and like any other hospital, we only have a finite amount of resources, so that was a great benefit.”
She said the greatest benefit is easier access to images for physicians. They no longer need to be in the cardiology department to view images. “Centricity Cardio Enterprise has made it much easier for physicians to get access to images, improved our efficiency and workflow, reduced the time it takes per procedure by 15 to 20 minutes, and has enhanced the cardiac care we offer,” Ryan explained.
The ability to view images from anywhere with an Internet connection has helped physicians provide more timely help.
“A lot of times our cardiologists are not the attending physicians, and so they’re being asked by another physician for a consultation and to discuss their findings,” Ryan said. “Before, that was much more difficult to do, because the doctor would have had to come to the department, which was not always possible.
This article served as an introduction to the cardiovascular ultrasound chart that ran in the May-June 2014 issue of DAIC. Click on the comparison chart tab at the top of the page to access the most recent chart. Chart participants include: