This past weekend was the American College of Cardiology’s annual meeting held in Chicago March 24-27. This year was an exciting year as there were major product announcements, but disappointing in that cardiology still appears to lag in terms of integrated cardiovascular information systems that will be essential to addressing ARRA/MU and the changing healthcare environment!
Here are a few of the more exciting developments from the ACC12:
Growing emphasis on cardiovascular services management
While the ACC12 did not seem to place great emphasis on ARRA/MU, the impending implication of its impact is beginning to affect Cardiovascular Information Systems (CVIS). Several vendors appear to be paying greater attention to the need to address all of a cardiovascular department’s services.
Philips appears to really understand this. Several years ago they acquired a company known as TomCat (renamed Philips CVIS), and they have spent the past years learning its capabilities. This year, Philips reintroduced (soon to be available) the capabilities of TomCat in a whole new product core known as Philips IntelliSpace Cardiovascular. The core product provides the underlying patient and study management base for all cardiovascular activities. Add-on applications enable study documentation and image capture and reporting capability that rely on their core competencies, such as Xper for Cardiac Catheterization, and Xceleris for Echocardiography. The major benefit is the ability to manage a patient through an entire cardiac episode, from say the initial ECG to the Echocardiography study, to a cardiac catheterization, to anti-coagulant therapy, to cardiac rehabilitation.
Similarly, a small company known as MedStreaming provides a cardiovascular physician office practice management application and electronic medical record, enabling smaller practices to go electronic. Lumedx demonstrated works-in-progress extensions to their extensive dashboard capabilities that present critical financial information on the state of department operations. Lumedx also showcased their HealthView application that makes it possible to see a unified view of patient information across the cardiologist office practice and the hospital.
Siemens demonstrated further advancement in terms of integration of patient and study management capabilities in their syngo Dynamics platform, as did GE with their new Centricity Cardiology offering. Merge has taken the approach of partnerships to address patient and study management, most notably its integration with Cerner’s PowerChart Cardiology. Several other vendors including Fuji continue to show works-in-progress developments to address patient and study management.
The net result is a slow but growing awareness of the need for CVIS functionality in conjunction with HIS/EMR deployments to address ARRA/MU requirements. In addition, legislative changes are forcing the integration of cardiologist office practices into provider-based cardiovascular services, which will force a broader perspective to visualizing and managing the patient through the entire range of care.
More sophisticated reporting tools
Cardiology has been progressive in its use of structured reporting versus dictation. Structured reporting provides more consistency to reports, and is much more manageable given that many cardiovascular reports contain many redundant measurements. Original structured reporting applications used a form of decision tree that the user progressed through to enter results, which then populated to a facsimile of a printed report.
The latest approach exhibited by a number of vendors is a variation of the “What You See Is What You Get” or WYSIWYG. In this approach, the user works directly from a facsimile of the report, and can make changes/additions by hovering over the area, which pops up a data entry window. Agfa and Merge are moving aggressively in this direction.
For Cardiac Catheterization reporting, frequently, “tree diagrams” are used to indicate blockages, location if stents, and anomalies. There seemed to be a greater number of vendors that are expanding their use of such interactive diagrams for reporting, most notably Provation and Fuji (works-in-progress).
Another trend is in the evolution of user interfaces that depict how users present the information available for a patient. Several vendors, notably Siemens, Philips and Agfa demonstrated new work list approaches involving unique ways of showing not only the studies available but status and information about the study. For example Siemens and Agfa both use dynamic icons that provide status and additional information on the study. The Philips IntelliSpace application presents the user with a dynamic time line of procedures that visibly show the time frame when the study was done, as well as other status information on the study.
All of these approaches are aimed at making it easier for the Cardiologist to do their interpretation, as well as making the process more productive by through the use of status information. As cardiovascular services are integrated with HIS/EMR systems, this will be valuable in terms of productively managing the patient.