Top Medical Center’s CVIS Now Handles Echo Management

One digital solution transforms cardiology department, echo labs and the patient care they provide.


August 30, 2006
The techs prepare all reports directly on Horizon Cardiology, and according to Jon Speaker, left, this has made them better techs, thanks to the volume of information Horizon Cardiology captures.

Situated in America’s heartland, St. Elizabeth Regional Medical Center is a healthcare leader for metro Lincoln, NE. It has been rated one of the Top 100 Hospitals by Solucient two of the past three years and recognized as a Magnet hospital by the American Nurses Credentialing Center for excellence in nursing.

St. Elizabeth’s approach is geared toward changing lives. With zero incidence of vascular complication and ranked in the 100th percentile as first of 401 hospitals, St. Elizabeth’s Heart Center continues to exceed state and national averages for cardiac procedure and surgery success rates. According to ACC NCDR “success rates” for percutaneous coronary interventions, the hospital is considered one of the top medical centers in the U.S. for the fastest response time for heart attack patients, rated in the 92nd percentile for the proportion of STEMI patient door-to-balloon time.

It is no surprise, then, that the heart center uses the latest and most advanced information technology system to improve patient care. The center provides full-service cardiac care, including echocardiography and vascular ultrasound, catheterization and electrophysiology labs, event monitoring, nuclear stress testing and open heart surgery.

Within the hospital’s three echocardiography rooms, Horizon Cardiology for echo has helped transform the busy lab with an efficient, digital infrastructure.

Out With Video

For Bruce Couillard, director of Cardiac and Vascular Services, and Jon Speaker, lead echo technician, it was obvious that digitizing the echo department with a Web-based solution would improve productivity, deliver tangible cost savings and enable cardiologists to deliver more efficient patient care. The immediate measurable benefit would be to eliminate videotape.

“Video is bulky, slow and has poor image quality,” Couillard said. “If a cardiologist wanted a copy, we had to access our logs, dub the tape and then send the video. Plus, we had already run out of space to store all those studies.”

The center resorted to storing video off-site, which increased department operating costs.

Although the cath lab was using – and was pleased with – McKesson’s Horizon Cardiology cardiovascular information management solution, Couillard wanted to consider all options for an echo management solution. Again, McKesson’s capabilities surpassed the competition.

“Horizon Cardiology and its echo component handle all of our needs,” Couillard said. “Having one system for the entire cardiology department is definitely a plus.”

The echo labs went live on Horizon Cardiology for echo in March 2004, at the time joining the cath lab and radiology department as the first clinical areas to implement a digital infrastructure. According to Couillard, the hospital is currently preparing for a move to an electronic health record (EHR) environment.

From the beginning, Couillard and Speaker believed the biggest benefit of a digital echocardiography management system would be the elimination of videotape. But it actually paled in comparison to workflow efficiency and enhanced patient care.

“Horizon Cardiology has completely transformed our lab,” Speaker said. “We are much more efficient and more effective when dealing with patients, cardiologists and others in the hospital.”

For Speaker, the greatest workflow improvement has been the ease in researching patient data, including pulling and comparing prior images and reports.

“I no longer call medical records; I just pull up the prior study on the system, which means I can focus on providing patient care,” he said.

Implementing a paperless department is another workflow improvement for both the techs and cardiologists.

“Cardiologists can access any echo or vascular ultrasound image and report through our hospital’s intranet,” Speaker added.

As an interim step to a paperless environment, McKesson worked closely with St. Elizabeth’s to implement a network print/fax system that replaces hand delivery of preliminary and final reports. Prelims are faxed to the floor where the nurse can put them into the patient chart, saving valuable time when every second counts.

Efficiencies for Cardiologists

“Once a cardiologist finalizes a report, it is automatically sent to the ordering cardiologist, the referring physician, the reading cardiologist and, if the study is on an inpatient, to that unit, without anybody touching anything,” Couillard said, adding that report turnaround time has been cut 75 percent.

By enabling seamless access to priors, Speaker and Couillard are convinced the patient receives a better diagnosis.

Enhancing patient care involves more than the tech or cardiologist processes. Horizon Cardiology has also benefited cardiologists in their time to diagnosis.

“Before the cardiologists go home, they read their last echos of the day and finalize and distribute their reports to the office, the floor, to all applicable caregivers. Horizon Cardiology has dramatically cut the turnaround time of this process, from 24 to 48 hours to less than 12 hours,” Couillard said.

Clinicians are ecstatic as well. David Bingham, M.D., is a vascular surgeon who reads studies using Horizon Cardiology’s Web feature.

“The fact that I can use the system remotely and the report is on the chart within minutes is fantastic,” he said. “It is more efficient for me because I can work reporting into my schedule rather than travel to the hospital just to read studies.”

Beyond patient care, workflow and staff efficiency benefits, Horizon Cardiology has also helped Couillard operate a more cost-effective department. Delivery costs for video have been slashed, plus medical transcription costs and medical record-related costs have been eliminated since all reporting is done online — overall, the equivalent of a $40,000 full-time employee.

But the most important benefit has been the department’s ability to provide timely, accurate and efficient patient care.

“Our McKesson Horizon Cardiology solution for echo is a standout system in this hospital,” Couillard said. “With the Web application, our clinicians can pull up patient images and reports anywhere — in fact, one of our clinicians is at another hospital and pulls up the McKesson application on a different workstation.”