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About Brigham Cath - Statistics

Cardiac Catheterization Lab Integration Project Frederic Resnic, MD, FACC Brigham and Women’s Hospital Harvard Medical School Boston, MA, USA. About Brigham Cath - Statistics. 5 Cardiac Catheterization labs Completely remodeled in 2000 4000 Diagnostic procedures annually

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About Brigham Cath - Statistics

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  1. Cardiac Catheterization LabIntegration ProjectFrederic Resnic, MD, FACCBrigham and Women’s HospitalHarvard Medical SchoolBoston, MA, USA

  2. About Brigham Cath - Statistics • 5 Cardiac Catheterization labs • Completely remodeled in 2000 • 4000 Diagnostic procedures annually • 1800 Interventional procedures annually • 700 Peripheral procedures annually ACC Scientific Sessions

  3. ACC Scientific Sessions

  4. About Brigham Cath - Systems • Brigham-developed Hospital Information System (HIS) known as “BICS” • Philips Integris Angio Systems • Witt Hemodynamic Systems • Agfa Scheduling and PACS system • LUMEDX ACC NCDR submission system ACC Scientific Sessions

  5. ACC Scientific Sessions

  6. Cath Lab Integration Project Goal Dramatically change and improve the workflow in the cath lab. ACC Scientific Sessions

  7. Cath Lab Integration Project Motivation • Personnel efficiency – entering data (accurately) into multiple lab systems • Determining “status” of exam • Speeding up “lab turn-around” time • “Finding” the patient record in the hemodynamic system (e.g., patient name spelling or patient ID transposed) • “Finding” the images in the digital archive • Expedite charges and billing (centralize and validate information to reduce time lag) • Handle exceptions to basic workflow: • Change rooms during procedure- avoid reentering data all over • Unscheduled/unknown patient -“John Doe” reconciliation ACC Scientific Sessions

  8. Cath Lab Integration Project Process • Facilitate discussions between vendors to determine how and what information to communicate (“define the standard”) • Vendors went away to perform implementation • Track vendor implementation status • Try implementations in “live” lab • Find errors, go back to steps 1 or 2 • Took a long, long time (2+ years) ACC Scientific Sessions

  9. LUMEDX NCDR Cath Integration- Pre-procedure BICS (HIS) Witt Hemo Patient, order, and procedure info Agfa ICIS Philips Integris Patient and order information Procedure status Agfa PACS ACC Scientific Sessions

  10. LUMEDX NCDR Cath Integration- Post-procedure NCDR Data BICS (HIS) Report Witt Hemo Patient, order, and procedure info Report Agfa ICIS Philips Integris Patient and order information Procedure status Images Agfa PACS ACC Scientific Sessions

  11. ACC Scientific Sessions

  12. Realized Benefits • Accurate and automated patient demographics • Happier technologists (less busy work –typing) • Fewer interruptions for Cath Lab Flow Manager (procedure status and cancellations) • Faster room turn around time • Better communication between cath lab teams • Improved efficiency of billing • Providing data to be able to optimize resource utilization ACC Scientific Sessions

  13. Integrating the Healthcare Enterprise (IHE) • Is IHE going to fix this multi-vendor integration problem for us? • Speed of implementation in a hospital? • Technical specification between vendors? • Simplify purchasing process? • Pre-tested/integrated software (not “live in lab”)? • Upgradable/standard software releases (no “one of a kind” software)? ACC Scientific Sessions

  14. General Conclusions • End goal was correct and project was successful, but… • Vendor integration process was painful and time consuming • We hope we have avoided potential software upgrade problems in future (specially developed software) • Get to be good friends with software developers from companies ACC Scientific Sessions

  15. IHE Conclusions • Our cath lab integration design is very close to IHE Cardiology “Cardiac Catheterization Workflow Profile”. It works. • Next time we intend to specify IHE in our purchasing RFP and avoid the entire design, specification, development, integration, and test phases. • Let IHE do it for us. ACC Scientific Sessions

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