Facilities today compete with each other to attract patients, produce state and federally mandated quality metrics, and live in an unstable reimbursement environment. The days of collecting and storing clinical and patient data in disparate information systems are over.
More and more hospitals and healthcare systems are installing cardiovascular information systems (CVIS) that give clinicians and staff convenient, quick access to the information they need to make important clinical and administrative decisions, as well as provide critical benchmarking data that are increasingly being tied to reimbursement.
The Mid America Heart Institute at Saint Luke’s Hospital, Kansas City, Mo., is a prime example. Because Saint Luke’s performs a high number of cardiovascular procedures in a year—from screening to transplants to rehab—it needed a CVIS that could unify disconnected data and make the information available to users in real-time. And physicians at Saint Luke’s knew that sophisticated reporting was critical to a large program like theirs.
Saint Luke’s had already been using several integrated modules of the Lumedx CVIS to simplify and consolidate the flow of information within the cath and EP labs and the transplant department when it decided to go deeper by implementing CardioManager performance management software and the Apollo Advance clinical data repository module. Cases created in the Mac-Lab hemodynamic recording system (GE Healthcare) automatically go into the Apollo data repository, says Lijia Lyles, clinical programs applications specialist. And CardioManager makes it easier to examine quality metrics such as cath outcomes, physician times and more.
Saint Luke’s did not submit data to the American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR) prior to implementing the latest modules. Staff had done internal benchmarking, similar to NCDR, but now they report data to the registries, as well as perform more internal benchmarking, Lyles says.
Integration is key
The Heart & Vascular Center in the Cape Fear Valley Health System, Fayetteville, N.C., accommodates nearly 5,000 diagnostic and therapeutic visits to the cath lab each year, according to Emily Thorne, network coordinator for multiple centers in the system. Without hard evidence, physicians and staff at Cape Fear could only guess where improvement was needed. But with a comprehensive CVIS, hard evidence is no longer a scarcity.
Cape Fear has integrated its image and data management, postprocessing and reporting using syngo Dynamics, coupled with real-time data transfer with Sensis, a hemodynamic recording system, both from Siemens Healthcare. Data mining now is easy, Thorne says.
In the past, counting monthly procedures for the echo and cath labs was quite a burdensome task. Logbooks were kept that had an entry for each patient and procedure. At month’s end, one would have to “slice and dice and count and recount the data” to ascertain the number of procedures. Their solution: They created a query that lists the patients and procedures, which exports to a spreadsheet where they can manipulate the data much faster and easier.
Cape Fear wanted their cath labs to become more efficient. So, they queried sheath pulls: who pulls and where the sheath is pulled. “We saw that cath lab personnel pulled most sheaths in the cath lab,” Thorne says. The solution was to have pre- and postprocedures occur outside the cath lab in the appropriate areas, thus making the cath lab more efficient.
Making querying easy
Jeffrey A. Breall, MD, director of the cardiac catheterization laboratories and interventional cardiology at Krannert Institute of Cardiology, Indiana University, Indianapolis, Ind., speaks of the ease of querying the ProSolv Cardiovascular system (Fujifilm Medical Systems). In fact, the system replaced a full-time person because relevant data can now be pulled in seconds.
“The system has a very open architectural data base, so it’s very easy to query,” says Breall. “Instead of one to two FTE to go through charts and pull out data to send to quality assurance organizations or insurance companies, you can have these data automatically plucked out of the system and sent with the push of a button. It saves an enormous amount of time, energy and money.”
The practice’s data mining capabilities are “unlimited,” Breall says—stretching from lab values to gender, demographics, stent type, periprocedural MI, mortality and productivity.