In healthcare today, climbing to the top or staying there requires keeping up with the latest advances in technology that improve not only patient care, but a facility as a whole. That whole is made up of many departments that operate best when connected to each other and throughout the enterprise. Until just a few years ago, electronic reporting and connectivity wasn’t readily available to cardiology departments. As a result, cardiology felt left behind while other departments connected. Those days are over as new and improved cardiovascular information systems (CVIS) make their way to the center of cardiac care.
On the 50-mile drive to one of Cincinnati Children’s Hospital’s outpatient clinics in Batesville, Ind., pediatric cardiologist William M. Gottliebson, MD, director, MRI Cardiology, explains what he does when he arrives prior to seeing his young cardiology patients. “The first thing I’ll do is fire up the PC,” he says. In doing so, he has immediate access to patient records and images through Emageon HeartSuite Vericis Web Access, a CVIS product. He has at his fingertips complete reports of all his patients, as well as his colleagues’ patients he needs to tend to.
Gottliebson began working with CVIS in 2003, a month before he joined the 475-bed Cincinnati Children’s Hospital in Ohio, where 12,400 children are treated annually for cardiac problems. He says he can’t imagine working without it. “Knowing all that information and being able to get it all with a mouse-click is incredibly important, particularly when you are at home or when you are on call,” says Gottliebson.
Accessing reports remotely is just one of CVIS’ most convenient and popular features, along with viewing images from PACS. The Emageon CVIS is tied to the radiology imaging studies at Cincinnati Children’s, which includes x-rays, CT, ultrasound, MRI, nuclear medicine and fluoroscopy scans.
There is a CVIS revolution in progress, though it’s not fast-paced, and it’s something cardiology departments have been wanting for a long time. As more digital images become available in PACS, as hospitals become more connected and as more information is required for reimbursement and national registries, the need for a comprehensive image and information system also grows.
CVIS—as the image and information solution for cardiac care—provides everything a cardiology department needs, digital image management, archiving, reporting and workflow management. It links cardiac ORs, echo labs and cath labs—their records, PACS and modalities—with other hospital departments. In a couple of words, it’s cardiac central.
“In radiology, basically the workflow is driven by the creation and managing of images; cardiology is quite the opposite—it’s all information-driven,” says John Alex, director of CVIS at the 613-bed Rush University Medical Center in Chicago.
“Data really drive the day for cardiologists. So the capture of discrete information, and more importantly, the creation of actionable types of reports from this data are what’s really important,” says Alex, who adds he’s seen a lot of changes since joining Rush in 1986. Rush relies on GE Healthcare’s Centricity to manage their cardiology patient information. Echo, stress, electrophysiology (EP) and electrocardiogram (ECG) are integrated into CVIS.
Around since the late 1990s, CVIS debuted with a few kinks. In the last few years, vendors have done some fine-tuning and the systems now meet the needs of cath and echo labs in approximately 30 percent of the 1,500 hospitals with cardiovascular departments.
“[CVIS] was not very stable in the beginning; it was very difficult to manage,” says Alex. “The system itself has become more stable over the years. They’ve opened up more and more modules for different areas within cardiology.”
Now that the system kinks have been worked out, the industry anticipates annual growth of 10 to 20 percent as more and more hospitals need to be connected. To install a system, they will pay from $250,000 to more than $1 million, depending on the size of the facility.
Cumbersome versus a cinch
What a cardiologist needs first and foremost is information—historic, accurate, complete and ready at a moment’s notice. In the “old days,” before the implementation of CVIS, getting that information together was cumbersome, or nearly impossible in some cases.
“A paper chart on a patient who is very complicated becomes massive—they become inches and inches thick and then what happens