I just returned from the American College of Cardiology’s 2011 meeting in New Orleans. So what’s new from an information systems perspective? Here are my take away points, in no particular order:
Meaningful Use Posturing
As HITECH/Meaning Use (MU) comes closer to addressing imaging, has it impacted Cardiology Information Systems vendors yet? From the conversations I had, I would say, it is not central in vendor’s minds just yet. When asked what their position was on MU, most responded that it does not yet apply to imaging, and hence they are continuing to follow the criteria and will react and get certified when necessary. There is clearly an awareness of MU, but there does not seem to be as much “buzz” as in radiology with respect to its impact.
I find this interesting in that during a visit to a highly regarded east coast teaching hospital last week to discuss echosonography reporting requirements, it occurred to me that at least one MU criteria is being generated within cardiology reporting systems, namely Body Mass Index (BMI). Therefore, wouldn’t cardiologists be more qualified than radiologists? When queried on this, most vendors agreed, but still felt that the emphasis is on EMR’s and consequently it is not yet an issue.
The Awakening of the CVIS
In my consulting practice I have found that it is often difficult to get everyone on the same page with respect to definitions. In my time with vendors at the ACC, I postulated a comparison of Cardiology PACS (CPACS) and Cardiovascular Information Systems (CVIS) definitions to compare notes. My perspective is that the classical CPACS addresses image management and reporting capabilities, while the CVIS overlaps with reporting, but emphasizes study, patient, and administrative management aspects similar to a Radiology Information System (RIS). All of the vendors I spoke with tended to agree with my definitions and liked the way I structured it.
In terms of product development, there seems to be an awakening of the importance of the CVIS, and the integration with a CPACS. Of particular note was Siemens, who has previously supported two platforms, syngo Dynamics as a CPACS, and Soarian Cardiology as a CVIS. This year, Siemens demonstrated their convergence by moving away from Soarian Cardiology by adding CVIS functionality to syngo Dynamics. While this has always been a stronghold for Lumedx, other vendors such as DR Systems, Fuji and Philips seem to be emphasizing the importance of integrated CPACS/CVIS platforms as well.
I heard a lot more discussion on the perspective of the electronic “white board,” resource scheduling, and benchmarking. To date this seems more prevalent for cardiac catheterization than echosonography, nuclear medicine, and other cardiac procedures. But ultimately to better integrate with EMR solutions, it will become more pervasive.
Collaboration versus Consolidation
By my count, the number of vendors addressing cardiovascular information systems continues to grow! Given that MU is not yet an impact; it would seem consistent that this is the case. My gut tells me that as soon as MU impacts cardiology imaging, there is likely to be some consolidation, as vendors confront the reality of further investment and certification. Further impacting this will be how far the lines of demarcation are blurred between Hospital Information System (HIS) vendors and Departmental Systems (CVIS) vendors. HIS vendors appear to be addressing cardiology today by collaboration, as evidenced by Merge Healthcare’s ability to collaborate with the likes of Cerner and Allscripts, and by Epic’s hospital information system (HIS) extension into CVIS with its Cardiant product. Interestingly enough, Epic failed to exhibit, which continues to add fuel to the debate over addressing cardiology’s needs via the HIS, versus dedicated applications such as the CVIS.
I was also struck by how many vendors embracing TomTec for 2D/3D/4D Ultrasound, including large vendors such as GE and Philips. And aside from a few vendors that have their own solutions, Epiphany seems to have garnered a piece of the ECG capture and reporting market. All of these collaborations seem to be aimed at enabling vendors to round out their product offerings and present customers with one-stop shopping.
Hospital To Home (H2H) Display
Last year, the ACC featured the integrated hybrid cardiology suite. This year, there was a similar display featuring the continuum of healthcare from hospital to home for cardiac care. The display featured the management of three different patients from their hospital encounter all the way to their follow up in the home, including such product as home telemetry and medication dispensing.
Cardiovascular information systems are evolving, and the H2H exhibit was a great example of the need for a boundary-less environment. The prospect is certainly bright for CVIS technology to capitalize on the electronic technology as a means of improving the quality and cost of healthcare.
All in all, another exciting ACC.