CVIS Across the Enterprise: Transforming Reporting & Image Access at Northwestern

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The vision was clear. The experienced heart and vascular team at the Northwestern Medicine Bluhm Cardiovascular Institute in Chicago needed a cardiovascular information system (CVIS) to stretch across its seven hospitals and 100 ambulatory care centers, physician offices and clinics. Like an architect constructing a solid foundation, they brought in a unified IT infrastructure to support enterprise-wide image reading, viewing, smart structured reporting and drive better quality, outcomes and efficiency. For this leading-edge health network, syngo Dynamics (Siemens) emerged as the enterprise-wide solution of choice for exchanging key patient images and data with the EMR, enabling near-instant, secure, HIPAA-enabled access to clinicians onsite and remote and ensuring interoperability across the enterprise.

Northwestern Medicine (NM) blends academic and community medicine, providing care in its hospitals and ambulatory care locations in the Chicagoland area via more than 4,000 practicing physicians and 30,000 employees. NW also represents the consolidating U.S. healthcare landscape. Once a series of independent hospitals, Northwestern Medicine has come together as one system.  Located in downtown Chicago, Northwestern Memorial Hospital is the flagship 894-bed academic medical center and  primary teaching affiliate for the Northwestern University Feinberg School of Medicine. To the north in Lake Forest isthe 201-bed Lake Forest Hospital. To the west are Northwestern Medicine Central DuPage Hospital (CDH), a 392-bed acute-care facility located in Winfield; Delnor Hospital, a 159-bed acute-care facility in Geneva; Kishwaukee Hospital, a 98-bed acute-care hospital in DeKalb; Valley West Hospital, a 24-bed critical access hospital in Sandwich and Marianjoy Rehabilitation Hospital in Wheaton.

Becoming one integrated system precipitated a move away from a series of siloed legacy IT systems repeated across multiple hospitals. Northwestern Medicine needed to unite people, processes and IT.

Defining the need

As the Northwestern Medicine heart and vascular team had outgrown their department-specific IT solutions, they searched out a mature CVIS that would integrate well with their EMR and could scale to their present and future needs. They also wanted structured reporting that creates enterprise-wide semantic interoperability using a unified ontology. In 2013, the consolidation of cardiology imaging and structured reporting on a unified CVIS started at Northwestern Medicine Central DuPage Hospital with the deployment of syngo Dynamics that now unites the entire enterprise. 

From the physician perspective, “the goal was to develop a single simplified and more efficient platform that standardizes and streamlines internal workflow,” says Joseph Schneider, MD, PhD, medical director for vascular surgery and interventional radiology at CDH. “Every doctor, including our physicians and referrers, needs access to every image and report. The CVIS enhances the physician and patient experience through better data consolidation and information sharing.” Total cost of ownership was reduced by eliminating the need to invest in departmental solutions and management. 

The vision from the IT side included hosting all images, regardless of specialty and type, in a vendor neutral archive (VNA), says Director of IS, Eleanor Lapidus. The VNA is interfaced with the EMR to query on every patient. “We wanted all of our physicians to be able to access images from the patient record through the EMR,” she says. “And they should be able to see the image regardless of the location where the image was acquired via a universal viewer.”

One of Schneider’s conditions in taking on the role of physician champion for this initiative was a guarantee from the IT department and the vendor that reports would be accessible in the EMR in the same way as radiology reports. The team made it happen. “All those things I asked for initially 10 years ago [with our old system], we finally got when we went live with this system,” Schneider recalls. “We also had the commitment of IT and vendor, which delivered the system to us well ahead of time.”

Joseph Schneider, MD, PhD, Northwestern Medicine Central DuPage Hospital

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Eating the elephant, one piece at a time

The plan to implement CVIS included a core team: a project manager from the IT side, the physician champion and a supportive IT department. Lapidus supported the team from the IT side, Schneider brought the physician perspective