Case Study | Cardiac PACS | May 26, 2015

An Ideal Transition: Multi-Campus Rollout of Echo CVIS at Orlando Health

Lumedx helps hospitals improve echo workflow

Lumedx, apollo, CVIS, cardiovascular data analytics, Orlando Regional Medical

Orlando Health recently successfully unrolled Lumedx’s physician structured reporting and image management solution across five of its campuses. The implementation was smooth and swift, user adoption is 100 percent, and the benefits are manifold.

About Orlando Health
Orlando Health is a not-for-profit healthcare system serving approximately 1.8 million Central Florida residents. The healthcare system includes six wholly owned hospitals, two partnership hospitals and a skilled nursing facility, for a total of 2,295 beds. With high volumes, cardiovascular services, one of the busiest service lines in the healthcare network, is always looking for new ways to improve efficiency, streamline care delivery and improve patient safety. The Lumedx cardiovascular information system (CVIS) helps Orlando Health accomplish this, and physician reporting is central to this effort.

Communicating for Successful Software Deployment
Avoiding the problems sometimes associated with large-scale software deployments required strategic planning and step-by-step communication with all stakeholders: leadership, clinical staff and physicians. CVIS administrators at the hospitals and the Orlando Health CVIS-Information Services team (Lisa McDonald-Barr, IT services senior project manager; Nancy C. Davis, RT(R), CV consultant; Nick Bergeron, IT system administrator; and Oleh S. Brezden, BSN, MHA, CHTS-CP IT clinical informatics specialist) worked closely with their vendor to develop a successful implementation plan.

Physician champions were engaged early in the process in order to ensure their suggestions were incorporated into any workflow changes and/or customizations. “When we started this project and talked to the physicians, we gave them the expectation that the new system would be more efficient, that repetitive tests would be eliminated, and that they would be able to see their reports right away,” McDonald-Barr said. “We’ve been able to deliver on all of those promises.”

McDonald-Barr, Davis and other stake-holders also developed online training modules for new users, and created a communication plan to keep physicians and staff informed of the status of the Echo CVIS project. “Many physicians and other clinical staff felt that regular, bidirectional communication about the implementation allowed them to know exactly what was happening — and to shape the solution — so that there were no surprises,” McDonald-Barr said.

Reducing Report Turnaround Time
“Prior to utilizing ApolloLX (Lumedx’s reporting system), physician reporting was a manual process — everything was dictated and transcribed,” said Scott Lynch, RRT, RDCS, manager of noninvasive cardiology at Orlando Regional Medical Center. “We needed to reduce the time it took to get a report completed and distributed. We also wanted to standardize our reports across the organization. Moving to an electronic system that connected directly with our EMR (AllScripts) was the obvious choice.” 

The CVIS has eliminated the need for dictation and transcription at Orlando Health facilities, saving time and money. Now once an echo is complete, it goes through the sonographer’s preliminary report and then is passed on electronically to the physician so he or she can read it. The physician can access the complete patient record — including images and notes — with a single sign-on. They can even read reports securely when they are remote. 

The new reporting workflow has trimmed 10-14 hours from report-completion time. And because reports are now automatically distributed to referrers, physicians no longer spend time on the phone giving informal reports to colleagues who needed patient information faster than the old system could give it to them.

Standardizing Reports 
“The American Society of Echocardiography is our governing body. When we started with our electronic reporting, we knew we needed to follow ASE guidelines for care,” Lynch said. The new solution was developed and implemented with ASE guidelines in mind. “The goal behind implementing electronic reporting is to strive for clinical best practice and bring every campus within our organization together so both the reporting format and the procedure would be standardized no matter what campus a patient visited. We wanted our patients to get the same care, the same best practices, and the same report at every campus,” he said.

Improving Quality, Developing Staff
Because the reporting solution automatically connects to the EMR, physicians and clinical staff across the continuum of care can access comprehensive, up-to-date patient reports. Cardiovascular service line staff can also easily review overall performance and determine areas for improvement.

For example, Orlando Health uses the new system to track whether or not a physician has read the sonographer report within 24 hours. It is also simple to drill-down to each individual physician in order to compare his or her average Echo report turnaround time with the network’s cumulative average. “Our leadership team can take a look at physician reporting to see how everyone is doing,” Davis explained. “It’s much easier for us to get the hard numbers and actually review how effectively we are working-and where can we can improve.”

Orlando Health also uses the reporting solution to evaluate sonographer performance, set network-wide standards, and improve the overall quality of sonographer reports. There is a tab built into the report that allows physicians to note the quality of a sonographer report as they are viewing it.

“One of our goals was to bring up the level of our sonographers. We wanted them all to meet the same consistent high standards, both at the bedside and in the report,” McDonald-Barr said. “Before, our sonographers were accustomed to only noting abnormal observations. With the new reporting workflow, they are prompted to report on everything. This makes the patient report more thorough.”

Results
All physicians, clinicians and staff are now using the new solution to complete reports.  And Dr. P. Phillips Hospital has recently received IAC Echocardiography (formerly ICAEL) program accreditation, the first hospital within the Orlando Health network to achieve this. “Without a doubt, our reporting solution has been instrumental in helping us meet the expectations and goals set forth by governing bodies like IAC Echo,” Lynch said.

“We had a great deal of physician engagement when we rolled out echo reporting. Now that we’re moving onto other projects, our physicians have expressed support and enthusiasm,” McDonald-Barr said. “Planning ahead and communication has paid off for all of us.”

Cost Benefits of Electronic Physician Reporting
By September 2014, all five Orlando Health facilities with adult echo were using the new reporting software. Of 1,987 echo reports, only 60 were dictated, leading to an overall cost savings of $8,238. With an average of 1,800 echos a month, over the course of a year Orlando Health could see a potential savings of $100,000 by using ApolloLX structured reporting instead of dictation and transcription services.

Orlando Health Hospitals With Echo CVIS:

• Dr. P. Phillips Hospital

• Orlando Regional Medical Center

• South Lake Hospital

• South Seminole Hospital

• Winnie Palmer Hospital for Women and Babies

 

This case study was supplied by Lumedx.

For more information: www.lumedx.com and www.orlandohealth.com

 

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