The urgency to transition the U.S. healthcare system to a paperless system has increased as the government has offered incentives to “get connected” and penalties for those who lag behind. Advances in image and report IT capabilities allow cardiologists to now provide seamless access to all patient data across hospital departments and facilities.
Poudre Valley Health System
Almost three years ago, Poudre Valley Health System (PVHS), based in Fort Collins, Colo., but spanning three states, started working with Philips Healthcare to more tightly integrate all of its imaging data with their EMR (Epic). The goal was to bring radiology, cardiology and other specialty imaging systems together as part of the overall EMR plan to provide one-stop shopping from providers. The next stages of the project, which should be completed in the third quarter of 2010, will involve upgrading the current hospital information system (HIS) from Magic to Client/Server (Meditech).
One of the main goals of this project was to have all images available in one system, the PACS (iSite, Philips). To do that, Gretchen Gibbs Allman, ancillary applications manager at PVHS, and her team needed to have an order entry application (radiology information system, or RIS), which both cardiology and radiology could use, to generate an accession number—a DICOM study’s identifying number. This is a challenge for many health facilities, Allman says, as many RIS applications are designed for the radiology workflow, not multidiscipline HIS systems like the one at PVHS. MediTech provides a module, called ITS (Imaging & Therapeutic Service), that can bridge all ancillary departments. ITS was designed with a multidisciplinary appeal, thus it can be used for placing orders and generating an accession number for many different modalities.
“One of our HIS’s greatest strengths is the modular integration,” says Allman. For example, demographic, patient specific account and medical record number (MRN) entered into the Meditech admissions module are directly accessed by the ITS module without interfacing. This saves time and increases accuracy. “We also needed this order information from Meditech to flow into our Philips systems and have the results from the Philips systems flow back into Meditech. The solution was to use an interface between the Meditech system and the various Philips systems. The interface allows patient demographics, account number, MRN and accession number to populate the worklists for the image systems. This also saves time and increases accuracy and, thus, improves patient safety,” Allman says.
Advice for shoppers
For facilities or practices looking to purchase a system that helps them seamlessly connect cardiology data with the EMR, Allman suggests ensuring that the order entry system, on the EMR or HIS side, is flexible enough to handle the needs of various areas.
Another key element is to ensure that upper management is dedicated to the vision to see projects through to their completion. In the case of PVHS, senior management had to ensure that everybody wanted to have a single registration system in order to share information across facilities. Even though the cardiology clinics at PVHS have their own ordering system (ECIS), they have signed onto the single registration system as well. “They do a very short double entry. They register into their own system and they register in ours, so that we have a common patient identifier to allow for cross-facility integration of patient care records,” Allman says.
Connecting practices to hospitals
A few years ago, Cardiovascular Consultants, a 38-cardiologist practice in Kansas City, Mo., had an IT manager and an IT staff, but no director of IT. That changed with the arrival of Kelly Lolli, who was hired to help better integrate the practice with Saint Luke’s Mid America Heart Institute. “It was important that the practice have a voice in hospital IT project implementations,” Lolli says.
The practice, as well, needed to modernize its IT security and the strength of its infrastructure. The EMR (NextGen) had been in use for about five years. It had been purchased before NextGen had a specific cardiology package. Over the years, the IT team has added many applications to enhance their workflow. “We have 100 percent utilization. All physicians