About Brigham Cath - Statistics

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Presentation transcript:

Cardiac Catheterization Lab Integration Project Frederic Resnic, MD, FACC Brigham and Women’s Hospital Harvard Medical School Boston, MA, USA I’ld like to talk about Brigham’s experience of taking one a large scale multi-vendor Cath Lab integration project on our own…

About Brigham Cath - Statistics 5 Cardiac Catheterization labs Completely remodeled in 2000 4000 Diagnostic procedures annually 1800 Interventional procedures annually 700 Peripheral procedures annually March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions March 13, 2006 ACC Scientific Sessions

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 March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions March 13, 2006 ACC Scientific Sessions

Cath Lab Integration Project Goal Dramatically change and improve the workflow in the cath lab. March 13, 2006 ACC Scientific Sessions

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 March 13, 2006 ACC Scientific Sessions

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) March 13, 2006 ACC Scientific Sessions

Cath Integration - Pre-procedure LUMEDX NCDR Cath Integration - Pre-procedure Witt Hemo Patient, order, and procedure info BICS (HIS) Agfa ICIS Philips Integris Patient and order information Procedure status Agfa PACS March 13, 2006 ACC Scientific Sessions

Cath Integration - Post-procedure LUMEDX NCDR Cath Integration - Post-procedure NCDR Data Report Witt Hemo Patient, order, and procedure info Report BICS (HIS) Agfa ICIS Philips Integris Patient and order information Procedure status Images Agfa PACS March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions 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 March 13, 2006 ACC Scientific Sessions

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)? March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions 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 March 13, 2006 ACC Scientific Sessions

ACC Scientific Sessions 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. March 13, 2006 ACC Scientific Sessions