In the same 20 minutes on my iPhone, I can order books, water filters, koi food, clothes, and electronics from Amazon, and have it all arrive within 2 days with free shipping. I can treat Google like an old-school encyclopedia index, peruse international news outlets, music and cute kitten videos from around the world all while taking the train home. My phone can help me navigate to a new restaurant or create for me an entirely new training regimen with daily workouts. My phone is a one-stop shop and I would be frighteningly lost without it. As consumers, we expect one stop shopping and convenient access to the exa-bytes1 of information found on the internet.
Meanwhile, there is a disconnect between what cardiologists and their staff likely expect as consumers, compared to what they have come to accept as healthcare providers. Unlike radiology, where providers have grown accustomed to sitting at a single workstation to review different types of studies, in cardiology there remains a lot of room for improvement in how cardiologists often access and review studies. In cardiology, providers have grown so accustomed to their dedicated analysis workstations that they might not even be asking for what is now possible with remote access to analysis tools and diagnostic studies.
Some sonographers travel literally up and down the stairs and across the hospital for each Stress Echo exam in order to import data into a combined Stress Echo report. Physicians still frequently have to manually enter stress results into a report and manually do calculations. One customer was actually able to save approximately 45 minutes per exam by just merging the data from a Stress ECG and an echo cart2. Although that sonographer and physician might have had great fitness tracker results from walking all over the hospital, I’m confident they could find better uses of their time and abilities.
Another example of this disconnect between expectations – I spoke with a cardiovascular anesthesiologist whose jaw dropped when I explained he might not need to carry a USB stick of echo studies from the operating room to a dedicated workstation in a reading room in order to analyze valve information. When I explained it is actually possible to do this analysis on virtually any system in the hospital meeting a minimum specification because these could be read & diagnosed remotely, and that he could even look at the CT study next to the echo study when planning valve surgery, he was incredulous and began to explain how this could help enhance planning and care for those patients.
If cardiologists use a single solution for the different types of studies and store discrete measurement results, findings and reports, they build a treasure trove of information that can help drive more informed treatment decisions. Ejection Fraction is the best predictor of long-term mortality3, and cardiologists can sit at the exact same computer to calculate it for different types of studies – no more walking across the hospital to different reading rooms. From that same system, they can finish their reports. That same treasure trove of data can be submitted to data registries, can be used for charge capture and inventory management, and administrative reports. MACRA brings a renewed focus on data registry submission in cardiology, and how convenient to have all this capability in a “one stop shop.” Such a one-stop-shop exists for cardiologists, service line directors, and cardiovascular staff. As they raise their expectations to ask for and eventually expect this type of capability, imagine the amount of time that could be now freed up – perhaps less time with the computers and more time with the actual patients!
2 OSUMC video testimonial
3Halkin A. et al. Prediction of Mortality After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: CADILLAC Risk Score. JACC 2005; 45:1397-1405