Cardiology PACS Integration The Heart Hospital, Baylor Plano

Transcription

1 Cardiology PACS Integration The Heart Hospital, Baylor Plano Herman Oosterwijk, OTech, Inc. Christopher J. Oropeza Richard Sanders Lori Crissup Provided by ITN and OTech Inc. Sponsored by GE Medical Systems 2009 OTech Inc.

2 Introduction Herman Oosterwijk: President OTech, Inc. Christopher Oropeza: Enterprise Imaging Administrator Richard Sanders, RN: Cath Lab Manager Lori Crissup, RN: Cardiology RN/IT Manager 2009 OTech Inc. Page 2

3 Heart Hospital Background (Richard) $100 million, 68 beds Opened Jan 22, 2007 Free standing cardio vascular hospital, Collin County, TX Mission: maximizing delivery of safe, quality and compassionate healthcare 2009 OTech Inc. Page 3

4 Project Background (Chris) 7 month implementation timeline 100+ Baylor Info Systems resources 70 IT projects 70 interfaces 8 new systems to the organization 3 systems implemented within 90 days Staged off-site prior to installation to test Exam dictionaries are essential 2009 OTech Inc. Page 4

5 System Description (Chris/See Diagram) GE PACS 3.2: EMC SAN CX300 SATA with HP 1.9TB and long term Centera (11 TB) 3 DAS gateways IDX imagecast Powerscribe and DMS structured reporting CVIS 2.0 for review Cloverleaf interface engine ConnectR IDX Interface engine 2 worklists: CVIS and radiology; ONE ADT GE centricity enterprise 2009 OTech Inc. Page 5

6 THE HEART HOSPITAL Baylor Plano Current RISIC/ Enterprise Imaging Interface and Image Transfer Cath Labs x4 CVIS/DMS Reporting Workstations x4 DICOM Image Send OR Suitesx4 Sequoia s x4 Cath/EP Lab x1 EP Labs x4 CVIS/DMS Reporting Workstations x3 DICOM Image Send Created by: Christopher J. Oropeza Rev. A: 01/31/2009 DICOM Image Send DICOM Modality Work list DICOM Modality Work list DICOM Modality Work list PACS QDX Hl7 Engine CVIS/DMS Results OB ORU^RO1 Orders In ORM^001 Results In ORU^R01 ConnectR Hl7 Engine RISIC Orders In ORR^002 Oders Out ORM001 Charges Out DFT ADT In ADT In ADT In Results ORU^R01 Schedule\Exam Orders In ORM^001 Charges OB DICOM Image Send DICOM Modality Work List PATCOM ADT In Charges In DFT ADT In Baylor Clover Leaf HL7 Engine SoftMed Results In ORU^R01 Schedule\Exam Orders In ORM^001 Orders Out ORR^002 Siemens E-Cam Siemens Sensation 64 Siemens Sequoia x3 CVIS/DMS Reporting Workstations Stress lab x1 Card RR x1 RA1000 Power Scribe Integration Diagnostic WS x2 PACS Tech Workstation x7 Radiology Modalities Diagnostic WS Kodak CR825 TeraRecon & Power Scribe For Cardiologist GE Centricity ADT OB Enterprise 2009 OTech Inc. Page 6 Results In ORU^R01 GE AMX DR Portable

7 Hemodynamics (Richard/Lori) GE Mac-lab for hemodynamics and Cardiolab for EP ADT info used to feed Orders goes to scheduler Patient is selected, case started and Hemodynamics and ECG goes to DMS server Reporting added and results Mapping from Mac-lab to imaging system Images can be pulled in report Reports can go to offices Referring physicians get fax 2009 OTech Inc. Page 7

8 OR Solution (Chris/Richard) PACSweb integrated on boom and 50 wall monitors Nurse accesses information Cath lab and surgical team both work in OR MAClab monitors available 2009 OTech Inc. Page 8

9 Issues Exam dictionaries not consistent Different systems have different record lengths Cardiology results posting in RIS More stringent workflow testing and cardiology staff education: schedule, arrive, begin, completion Downstream systems might be out of sync (complete status) Mismatches require clean-up and prevent physicians completing reports Hemodynamics input linked to charging: issues with lacking ADT 2009 OTech Inc. Page 9

10 Lessons Learned Transition by physicians from dictation to computer entry difficult High quality reports: use Structured reports with images included Finish results and fast completion Run discrepancy reports Crystal reporting used to access database Monthly reports about #cases 2009 OTech Inc. Page 10

11 Lessons Learned (cont.) Administrator database access One password for centricity (DMS) Same username for main hospital domain Challenge to have one password (single sign-on) 2009 OTech Inc. Page 11

12 Architecture Single repository Single folder for cardiology and radiology Patient room provides access to images for review using PACSweb 2009 OTech Inc. Page 12

13 Final Recommendations Passwords issues Stringent RIS workflow testing Tough to get physicians on board: more training Future web based report confirmations Workflow support is critical 2009 OTech Inc. Page 13