At Cooper Health System in Camden, N.J., which encompasses a 500-bed urban university hospital and over 80 physician office locations, Phil Curran, CIO, and Rose Alapatt, applications analyst, have been helping to lead innovation in a number of areas, one of which has to do with cardiology. As in other hospital organizations nationwide, the cardiologists at Cooper Health System found themselves struggling to manage the ever-expanding welter of images and data they need to work with in order to best serve their patients. So beginning in late 2008, Curran, Alapatt, and their colleagues began looking into vendor solutions in the cardiology area. What Curran and Alapatt knew from the outset was that cardiology image management is very different from radiology image management, for a variety of reasons.
Asked whether they believed initially that implementing a cardiology image management system would be similar to implementing a radiology PACS, Curran says, “We never made that assumption. And we work very closely with the cardiology folks, and they flat-out told us, we need more information, we need to manipulate the images differently; so it's not a cardiology PACS system.”
For one thing, as Alapatt notes, “Cardiology images are moving images, whereas the radiology images are still,” meaning that any kind of image management system in cardiology must be very robust from the get-go. Indeed, she reports, “Four of our five outside offices do images, and we did have to increase the bandwidth from those offices to our cardiology information system at our data center. We figured out the average number of bytes per image, figured out how many images would be taken during a day, added that to the amount of bandwidth that they already had, and added that much more bandwidth to those four offices” in preparation for the go-live, she says.
After vetting several products, the folks at Cooper ended up going with the Horizon Cardiology cardiovascular information system (CVIS) from McKesson, going live with the CVIS in the spring of 2010, and interfacing it with the hospital's core EHR, from the Verona, Wis.-based Epic Systems Corp. As of press time, the CVIS, which is web-enabled, is fully implemented for echocardiology and vascular medicine, across about 12 modalities, and across the hospital's main campus and four satellite locations. Any clinician with appropriate access to the CVIS can now view an image or interact with the system from any PC across the health system. What's more, virtually 100 percent of the cardiologic images are going into the Epic EHR (which spans inpatient and outpatient care delivery), Curran notes.
“This was a very big team effort between cardiology and IT,” testifies Curran. He and Alapatt agree that having the cardiologists on board from the very outset has been essential to the success of their CVIS implementation. Another critical success factor, Alapatt says, is doing what the Cooper IT team always does, which is establish the goals and objectives before anything moves forward.
What would he advise other CIOs? Tellingly, Curran says that “If they don't have any type of PACS system in place yet, they need to think about getting all their ‘ologies’ into place in a coordinated way: radiology, cardiology, pathology, and so on. If they do have a radiology PACS system in place, they need to make sure the front end of the radiology PACS system works well with cardiology. And the third thing is to significantly reduce the physical footprint. They do need to consider virtualization; you can call it an internal cloud, if you'd like.”
Healthcare Informatics 2011 November;28(11):14
