Recently, I have again played patient by enduring some cardiovascular testing. As I have gone through the process with multiple clinicians (fortunately in a singular healthcare system), I am reminded of the benefit of why it makes sense to have cardiovascular information all in one place, and I am not so sure this is the case in this particular healthcare facility!
This comes at an opportune time, as I have been following cardiovascular information system developments for a number of years, and now I have a personal example of why they are important. For all clinicians to have easy access to all procedures, especially when they may cut across multiple service areas, is an important part of effective care coordination.
Procedures relevant to cardiovascular services may not always be in the same service area. Pulmonary services are sometimes separate, and as in my recent case, peripheral vascular ultrasound procedures are the purveyance of radiology. Sure, clinicians can peruse multiple systems to find results, but how much does this result in either missed or repeated studies or inefficiencies in accessing them? Wouldn’t it make sense for cardiologists to be able to access cardiovascular information all in one place?
One development that shows a lot of promise in this regard is the recently introduced Philips IntelliSpace Cardiovascular system (http://www.philips.com/intellispacecardiovascular).
IntelliSpace Cardiovascular provides a universal workspace that integrates a patient’s complete cardiovascular record (see Figure 1). The Philips solution addresses not only diagnostic procedures such as cardiac catheterization, electrocardiogram, and echocardiography, but can interface with ancillary areas such as pulmonary testing, heart failure, and cardiac rehabilitation services as needed. Clinicians have one place to manage and follow a patient through the complete course of cardiovascular care.
A unique element of IntelliSpace Cardiovascular is the time line that shows the cardiovascular encounter history of the patient graphically. A clinician can easily see the current and historical nature of all the patient’s encounters, reducing the risk of missing important diagnostic or treatment elements. The integration also makes it easy to see related diagnostic procedures without having to look in multiple places.
One might argue that this can be done via the Electronic Medical Record (EMR), as all (or most) exam results are accessible via the EMR. The distinction, as addressed in a prior blog, is that the EMR is not conveniently structured for the clinician to see all the exams without going through multiple service tabs, and it is certainly not easy to follow the chronology of events. Similarly, the clinician must launch either singular or multiple viewers to access the imaging content.
What Philips has done with IntelliSpace Cardiovascular is to present a user interface that is targeted to the clinician, and does present the chronological record of the cardiovascular patient history, along with a direct presentation of the imaging and clinical report content. This is further substantiation of why, as I have previously blogged, there is a differentiation between an EMR and a Cardiovascular Information System (CVIS), and a justification for both.
Another advantage of a singular cardiovascular record such as that provided by the Philips IntelliSpace Cardiovascular solution is the ability to do analytics. In an ARRA/MU world, it will be increasingly important for the administration of cardiovascular services to have operational and outcomes information at its disposal. This will help improve department operations, as well as the efficacy of clinical services. Similarly, the interoperability of a Cardiovascular Information System will enable it to take advantage of information from a number of ancillary systems, as well as provide analytical results to other systems.
As my cardiovascular diagnosis and treatment continues, it will be interesting to follow the ability to easily access all results. A well-known EMR is in place and does provide access to results, but accessing the actual exam data is more difficult. For example, the pulmonary test results are printed out and scanned into the EMR, when they could just as well be electronically interfaced to a Cardiovascular Information System.
I suspect two factors as the reasons CVIS systems are not more prevalent: (1) they are in their infancy and it will take some time for them to become more widely adopted; and (2) the cost/benefit tradeoff made by institutions that find it hard to make such investments, balanced against the clinical benefits.
One of the reasons for this blog is to get the word out – the technology is available, it’s time to make the tradeoff! I for one will be pushing this with my healthcare provider – especially if I see instances where the cardiovascular information is not maintained all in one place!