Cleveland Clinic, one of the nation’s leading healthcare facility, has upped the ante once again with the debut late last year of a new cardiac care facility equipped with state-of-the-art imaging with sophisticated diagnostic and treatment technology that is smoothly integrated with enterprise-wide clinical IT systems.
The new 278-bed Sydell and Arnold Miller Family Heart & Vascular Institute at the Cleveland Clinic houses an impressive array of systems and services: two dedicated robotic OR suites; a clustered diagnostic imaging center with echocardiography, MRI and CT systems; state-of-the-art cardiac cath labs and four distinct ICUs with same floor step-down units dedicated to specific patient needs. One conventional staple of 20th century medicine is missing from the high-tech campus: the institute is the first building on Cleveland Clinic campus without a single lightbox. The Institute deployed a cardiology PACS for viewing all clinical images, including dynamic movie clips from the cath lab and echo Doppler.
Planning for the Miller Institute offered a once-in-a-lifetime opportunity to develop and support a different paradigm in image viewing, reporting and distribution, says Robert Cecil, PhD, staff, Cleveland Clinic Foundation. Cecil and his colleagues seized the opportunity, connecting with vendors as partners in support of a vision focused on infusing images and imaging tools throughout the enterprise. The second part of the vision integrates radiology and cardiology at both the IT and clinical levels.
“There are so many opportunities to move from adequacy to excellence in healthcare,” Cecil says. “The technology to truly improve the quality and efficiency of patient care exists today.” Until recently, diagnostic imaging, specifically the flow of images among image-centric specialists, presented a major obstacle to achieving significant improvements in patient care.
Digital image management systems at Miller Institute are designed to erase the image flow obstacle, support state-of-the-art cardiovascular surgery and enable true excellence in cardiovascular medicine. This issue, CMIO tours the Miller Institute to provide a sneak peak at the future of cardiovascular medicine.
The dynamic duo: Patient care and efficiency
Improved patient care and increased efficiency often travel together. Continuity of care, or hand-off communications, represents the point. The Joint Commission promotes a standard approach to patient hand-off among various providers. In the typical cardiovascular surgery case, a cardiac surgeon operates on a patient and immediately moves on to the next case. Multiple clinicians and nurses share responsibility for the patient and visit him over the next few days in the ICU and step-down unit. During each clinical contact, the patient is bombarded with questions. Caregivers often repeat the same series of questions because the information provided to the previous caregiver is not readily accessible.
The answer to better efficiency, says Cecil, is the electronic medical record. “The EMR, spearheaded by Martin Harris, MD, CIO of Cleveland Clinic Foundation, makes it very easy to support continuity of care.” The Miller Institute, along with every Cleveland Clinic facility, uses an EMR to support communication and eliminate time-consuming, repetitious patient queries.
While an EMR helps sites cover the basics of clinical communication, it also supports care excellence. Cecil explains, “We’re seeing an aggregation of facilities.” Take for example complex procedures such as heart transplant surgeries. Hospitals need to maintain a minimum base volume to support the infrastructure and staffing resources required for the surgery. Large, specialized facilities, however, don’t operate in a vacuum. For sites like Cleveland Clinic to maintain excellence, they need to distribute quality care to allied facilities. Providers at every stage of the transplant process need to share information. The hitch, again, is communication among physicians. “The growing complexity of pre- and post-transplant care requires an ever-increasing need for physician-to-physician communication,” says Cecil. The EMR is a critical first step in supporting clinical communication and collaboration. It facilitates communication among physicians and keeps all providers in the clinical loop.
Digital image distribution is an essential part to the EMR. “Imaging is pervasive, and its importance increases as patients become sicker,” shares