Suffering from headaches? It could be your cardiology workflow

May 4, 2005

Despite their reputation for healing, most physicians experience a common ailment: workflow-related headaches. Cardiologists are not immune to this suffering. Heightened demand for services, an ever-increasing volume of images, and the associated reporting requirements lead to scheduling difficulties, unnecessary downtime, and simply too much effort spent chasing down and communicating diagnostic and interventional results.

Despite their reputation for healing, most physicians experience a common ailment: workflow-related headaches. Cardiologists are not immune to this suffering. Heightened demand for services, an ever-increasing volume of images, and the associated reporting requirements lead to scheduling difficulties, unnecessary downtime, and simply too much effort spent chasing down and communicating diagnostic and interventional results.

PACS is a clear solution to streamlining cardiology workflow. Although initially conceived as a method to better manage massive volumes of radiological images and data, PACS has spread to other departments, incorporating clinically specific tools and features along the way. The benefits of PACS are universal across the clinical enterprise: improved access to images and data, improved control over business processes, reduced redundancy, streamlined diagnostic reporting, and enhanced delivery of care.

It's true that cardiology departments have already embraced digital technology, with modalities such as cardiac catheterization and echocardiography that allow studies to be viewed on stand-alone workstations or department miniPACS. These types of "island" solutions, however, don't promote data sharing throughout the hospital and thus don't really translate into significant workflow improvements for the cardiologist.

In contrast, an enterprise PACS solution empowers cardiologists to review relevant multimodality images from any location within the clinical setting, or even remotely from an outside office or home, using a Web-enabled application. Cross-departmental access to images and report data plus remote consultation mean that cardiologists can gain a more comprehensive view while improving service to their patients and referring physicians.

Let's take a moment to run through some of the common pain points for cardiologists and discuss how PACS can make things better.

PAIN POINT #1: SCHEDULING

In a busy department like cardiology, procedure schedules change frequently. Unanticipated events such as emergencies, equipment failure, and procedures that bump over into neighboring time slots can leave cardiologists operating inefficiently.

A good enterprise PACS implementation provides real-time workflow updates, so cardiologists can get an accurate updated view of the day's schedule from their office or home computer without the need to call the cath lab directly. This helps to streamline scheduling, resource usage, communications, and patient flow.

Realistically, the critical nature of cardiac care means that some delays can't be anticipated. In these situations, PACS will help cardiologists to stay productive as well. A cardiologist faced with unexpected downtime. for example, can simply sign on to a PACS-enabled workstation within the enterprise and start reviewing images and generating reports.

PAIN POINT #2: CHASING RESULTS

In the typical cardiology "digital island" environment, echocardiography studies produce physical tapes or disk drives that reside in echo carts throughout the hospital. Chasing down these tapes not only wastes time, it's frustrating!

With PACS, echo results reside in backend systems and can, therefore, be accessed from any enabled workstation. PACS also lets cardiologists compare multiple cardiac results with radiological images such as CTA, MRI, IVUS, and CR. This multimodality comparison approach helps provide a more thorough diagnosis and treatment plan for patients.

PAIN POINT #3: PATIENT RECONCILIATION

Isolated departmental systems can make it difficult to effectively track a patient throughout the hospital. In the world of cardiac care, it's important that the correct images or data are mapped to the correct patient. This need for absolute certainty can cause unnecessary delays in a disconnected system.

In an integrated environment, where the enterprise PACS and the hospital information system freely share data, this isn't an issue. Effective tracking of a patient's complete record throughout the hospital provides confidence in patient/study matching.

PAIN POINT #4: OFF-SITE REVIEW

In a perfect world, all cardiology patients would visit the same hospital for diagnosis and treatment. In the real world, cardiologists see patients at multiple facilities. Physically visiting all of these facilities to review results consumes a vast amount of time.

Enterprise PACS solutions that offer Web-enabled viewing and reporting allow cardiologists to review results from wherever they are working. Enterprise PACS solutions that facilitate consultation with colleagues provide a more comprehensive view and a higher degree of confidence in diagnosis. The end result of these efficiencies is that cardiologists can spend more time in the office seeing patients.

PAIN POINT #5: REPORTING AND ONGOING CARE

With every patient, there is a referring physician who needs to be kept in the loop on diagnosis and treatment to ensure seamless delivery of ongoing care. The traditional dictation/transcription/snail mail approach can take more than a week to deliver results to a referring physician.

Enterprise PACS can enable reports to be sent electronically in a matter of seconds. This faster turnaround improves communication and relationships between the key stakeholders in patient care.

THE PACS PROGNOSIS

Enterprise PACS significantly improves workflow, not just within the cardiology department but across the clinical enterprise. Its ability to provide pertinent patient information to cardiologists, wherever and whenever they need it, empowers physicians to make the most efficient use of their time and departmental resources.

Ultimately, this means they are maintaining the highest level of care. The ability of PACS to link disparate "data islands" throughout the enterprise helps healthcare facilities to run more smoothly while supporting important industry initiatives such as Integrating the Healthcare Enterprise.

We conclude with a checklist of options to look for when integrating cardiology into an enterprise PACS environment:

  • Streamlined workflow: An integrated, multimodality structured reporting solution that communicates with the HIS facilitates accurate data entry and reliable access to all of a patient's diagnostic reports and images.

  • Integrated view of patient information: Enterprise PACS should store and manage data from multiple imaging modalities to provide an integrated cardiac image record. Providing all data to a single point of access empowers cardiologists to make confident diagnostic decisions based on the most complete information available.

  • User-friendly interface: Providing patient images and information in a comprehensive, analyzable, and easy-to-navigate format makes it easier to improve patient care.

  • Connectivity with IT systems throughout the enterprise: Integration with cath, echo, clinical information systems, and radiology improves the delivery of clinical care, promotes data integrity, and streamlines the workflow of the diagnostic and reporting processes within the department, the healthcare enterprise, and remote locations.

Mr. Fitzgerald is North American marketing manager, cardiology with Agfa. His experience spans more than 20 years in the cardiovascular domain ranging from clinical (cath tech/RN) to administrative (COO/CEO) duties in both acute care and physician group practice settings. He can be reached at brian.fitzgerald@agfa.com.

Mr. Nagle is global product manager, cardiology business solutions with Agfa's HealthCare business group. He has more than 19 years of experience in diagnostic imaging and healthcare information technology. He can be reached at brian.nagle@agfa.com.