ACC 2014 is now history! Washington, D.C. weather was perfect for a conference – it rained the entire weekend! Prior to the meeting I speculated about what might be new. In a nutshell, it was a fitting venue in Washington, D.C. as cardiology seems to be awakening to the world of meaningful use The following are some of my initial takeaways from meeting:
Appropriate Use Criteria
Several vendors “get it” in terms of applying decision support and appropriate use criteria (AUC) to cardiovascular services. These vendors are building appropriate use criteria into their templates to assist with medical decision making. As identified on the ACC website (http://www.cardiosource.org/en/News-Media/Publications/Cardiology-Magazine/Archival-News-Articles/Choosing-Wisely-Update.aspx), “efforts of the recently launched Choosing Wisely® campaign, of which the ACC and eight other specialty societies were original partners. The overarching goal of Choosing Wisely® is to promote wise choices by clinicians and patients in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions, and reduce the increasingly high cost of health care. To that end, the ACC and eight other specialty societies released evidence-based lists of tests and procedures for patients and physicians to question this past April. An additional 11 groups are expected to release additional lists in the coming months.” Vendors (example: Siemens) have used this material to include AUC in their reporting systems to better enable users to track appropriate use.
Greater Order/Study Management
As discussed in a previous article (http://www.healthcare-informatics.com/article/cardiovascular-information-systems), there are differing opinions over where orders should be managed and scheduled. Some believe that the EMR is taking over this role from an enterprise level from departmentals. There is likely some good from this in addressing patient care coordination, such as a logical flow of a series of procedures, or avoiding conflicts in specific procedures such as procedures impacted by contrast given in another procedure. However, there is still the issue of how a system uses this information as part of the study.
Several manufacturers are aware of the importance of order/study management capabilities, and address them head on. Other vendors still don’t seem to grasp the importance of doing so. Most at least have some capability for status messages to alert users to the status of the procedure. Philips (http://www.healthcare.philips.com/main/products/index.wpd) new CVIS (Cardiovascular Information System) application goes one step further and presents a graphical representation of current and historical procedures, including an indication of their status.
Some vendors believe scheduling is the prerogative of other vendors, or central scheduling. Others seem to understand that cardiology scheduling needs to be more granular than that of an EMR scheduler. For example, Lumedx (http://lumedx.com/) cited the example of managing the schedule for a cardiologist who might perform TEE procedures as well as cardiac catheterization procedures. What if a TEE procedure extends longer than planned, and the cath procedure schedule needs to be adjusted? Or what about different nursing teams? Another popular capability is the white board that can be used to update staff or patient families on the status of the patient. All these are reasons to consider order and schedule management capabilities of a CVIS.
Analytics Galore
With increasing emphasis on department management and research outcomes, analytics is another promising area of development. Many vendors can present “dashboards” for staff utilization, or procedural mix, but even more impressive are data mining capabilities of several vendors, most notably, Medstreaming, which are highlighted in a recent article in Endovascular Today, January, 2014, Volume 13, No. 1, Page 47. Medstreaming refers to “graphic fusion” or the convergence of graphical representation with data.
The diversity of cardiovascular procedures represents a fertile environment for data mining and analytics. Management will become increasingly reliant on such tools to better manage their practices in light of accountable care.
I have only scratched the surface in terms of what was shown at the ACC14. I think it is important that the industry appears to finally be placing more emphasis on the changes resulting from a changing healthcare legislative environment.
