Cardiovascular Business - March/April 2008 - (Page 23) “When you are trying to take care of the patient to make patient care decisions, you need all of the data available to you.” — James E. Tcheng, MD, professor of medicine and medical knowledge architect, Duke Health System the physician and the patient. “When you are trying to take care of the patient to make patient care decisions, you need all of the data available to you. And that is when you would work inside the electronic medical record,” says Tcheng. He points out that workflow is changed at the level of decision making. “Most physicians in the cardiology sector when they are faced with a critical decision—for instance, revascularization or management of heart failure—they want to look at the study themselves, and based on that, want to make that next recommendation or decision.” Two points of entry Aside from having the integrated solution in the EMR, studies are available in a stand-alone solution, which Tcheng calls their parallel DICOM-compatible universe for echocardiography and cardiac cath lab. Using the Xcelera CVIS, physicians can easily access a lot of studies by modality for interpretation and reporting. “In essence, we have created parallel universes trying to marry the information that is returned to the environment that the physician finds himself or herself in for maximal efficiency,” says Tcheng. “It’s a matter of time and convenience which universe you work in.” catheter interventions (TCIs), 6,000 echocardiograms, 2,000 electrophysiology (EP) procedures and 900 heart studies. Cardiac images are stored on a Lumedx CardioPACS. CardioPACS uses the St. Peter’s storage infrastructure, which is an EMC Centera. While St. Peter’s recently acquired a FujiFilm Synapse PACS, it continues to use CardioPACS for acquisition, storage and review of images in cardiology. Integration and upgrades are an ongoing process for St. Peter’s. Cameron says they began integrating cardiac information and images into the EMRs first with cath and then echo over the past few years. The transition was painless using “canned” integration from Lumedx. The information from the cardiology unit captured using Lumedx CardioDoc is automatically sent to referring physicians and integrated into the Siemens EMR. Images are available through a link in the record. Anywhere, anytime Access until recently was internal only when they began using Lumedx web access to provide physicians with offsite access to reports and images. “What we do differently from most other places is that a physician can line-in externally and internally using a single sign-on and get all the information from multiple systems and Smooth integration St. Peter’s Hospital has integrated Lumedx cardiology EMRs with the hospital’s Siemens Medical Solutions hospital-wide EMR system. Stephen Cameron, RCIS, RCS, program director for cardiac and vascular, says Lumedx is “internally interfaced with the clinical information system. So if a physician logs in in-house, he has access to lab values, discharge summaries, physician consults and pharmacy information. He also gets cardiology, EKGs online, graphics and motion. We also have cath reports, and we also have the actual film online and in motion.” Each year, the staff at St. Peter’s perform 3,000 cardiac catheterizations and trans- St. Peter’s Hospital has integrated the cardiology electronic medical records system with the hospital-wide EMR system. CardiovascularBusiness.com Cardiovascular Business 23 http://CardiovascularBusiness.com
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