Cardiology PACS Integration The Heart Hospital, Baylor Plano
Cardiology PACS Integration The Heart Hospital, Baylor Plano
Cardiology PACS Integration The Heart Hospital, Baylor Plano
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<strong>Cardiology</strong> <strong>PACS</strong> <strong>Integration</strong><br />
<strong>The</strong> <strong>Heart</strong> <strong>Hospital</strong>, <strong>Baylor</strong> <strong>Plano</strong><br />
Herman Oosterwijk, OTech, Inc.<br />
Christopher J. Oropeza<br />
Richard Sanders<br />
Lori Crissup<br />
Provided by ITN and OTech Inc.<br />
Sponsored by GE Medical Systems<br />
© 2009 OTech Inc.
Introduction<br />
•� Herman Oosterwijk: President OTech, Inc.<br />
•� Christopher Oropeza: Enterprise Imaging<br />
Administrator<br />
•� Richard Sanders, RN: Cath Lab Manager<br />
•� Lori Crissup, RN: <strong>Cardiology</strong> RN/IT Manager<br />
© 2009 OTech Inc. Page 2
<strong>Heart</strong> <strong>Hospital</strong> Background (Richard)<br />
•� $100 million, 68 beds<br />
•� Opened Jan 22, 2007<br />
•� Free standing cardio vascular hospital, Collin<br />
County, TX<br />
•� Mission: maximizing delivery of safe, quality and<br />
compassionate healthcare<br />
© 2009 OTech Inc. Page 3
Project Background (Chris)<br />
•� 7 month implementation timeline<br />
•� 100+ <strong>Baylor</strong> Info Systems resources<br />
•� 70 IT projects<br />
•� 70 interfaces<br />
•� 8 new systems to the organization<br />
•� 3 systems implemented within 90 days<br />
•� Staged off-site prior to installation to test<br />
•� Exam dictionaries are essential<br />
© 2009 OTech Inc. Page 4
System Description (Chris/See Diagram)<br />
•� GE <strong>PACS</strong> 3.2: EMC SAN CX300 SATA with HP<br />
1.9TB and long term Centera (11 TB)<br />
•� 3 DAS gateways<br />
•� IDX imagecast<br />
•� Powerscribe and DMS structured reporting<br />
•� CVIS 2.0 for review<br />
•� Cloverleaf interface engine<br />
•� ConnectR IDX Interface engine<br />
•� 2 worklists: CVIS and radiology; ONE ADT<br />
•� GE centricity enterprise<br />
© 2009 OTech Inc. Page 5
Cath Labs x4<br />
CVIS/DMS<br />
Reporting<br />
Workstations<br />
x4<br />
OR Suitesx4<br />
Sequoia’s x4<br />
Cath/EP Lab<br />
x1<br />
EP Labs x4<br />
CVIS/DMS<br />
Reporting<br />
Workstations<br />
x3<br />
THE HEART HOSPITAL <strong>Baylor</strong> <strong>Plano</strong><br />
Current RISIC/ Enterprise Imaging<br />
Interface and Image Transfer<br />
<strong>PACS</strong><br />
Orders In ORM^001<br />
Results In ORU^R01<br />
ConnectR Hl7 Engine<br />
RISIC<br />
Orders In ORR^002<br />
Results ORU^R01<br />
Siemens E-Cam<br />
Siemens Sensation 64<br />
DICOM Image Send Radiology Modalities<br />
DICOM Image Send<br />
Diagnostic WS<br />
DICOM Image Send<br />
Created by: Christopher J. Oropeza<br />
Rev. A: 01/31/2009<br />
DICOM Image Send<br />
DICOM Modality Work list<br />
DICOM Modality Work list<br />
DICOM Modality Work list<br />
QDX Hl7 Engine<br />
CVIS/DMS<br />
Results OB ORU^RO1<br />
ADT In<br />
Oders Out ORM001<br />
Charges Out DFT<br />
ADT In<br />
ADT In<br />
Orders In ORM^001<br />
Charges OB<br />
DICOM Modality Work List<br />
PATCOM SoftMed<br />
ADT In<br />
Charges In DFT<br />
ADT In<br />
Results In ORU^R01<br />
Siemens Sequoia x3<br />
CVIS/DMS<br />
Reporting<br />
Workstations<br />
Stress lab x1<br />
Card RR x1<br />
RA1000 Power Scribe<br />
<strong>Integration</strong><br />
Diagnostic WS x2<br />
<strong>PACS</strong> Tech<br />
Workstation<br />
x7<br />
Kodak CR825<br />
TeraRecon & Power<br />
Scribe For Cardiologist<br />
GE AMX DR<br />
Portable<br />
Schedule\Exam Schedule\Exam<br />
© 2009 OTech Inc.<br />
<strong>Baylor</strong> Clover<br />
Leaf HL7 Engine<br />
Orders In ORM^001<br />
Orders Out ORR^002<br />
ADT OB<br />
Results In ORU^R01<br />
GE Centricity<br />
Enterprise<br />
Page 6
Hemodynamics (Richard/Lori)<br />
•� GE Mac-lab for hemodynamics and Cardiolab for EP<br />
•� ADT info used to feed<br />
•� Orders goes to scheduler<br />
•� Patient is selected, case started and<br />
•� Hemodynamics and ECG goes to DMS server<br />
•� Reporting added and results<br />
•� Mapping from Mac-lab to imaging system<br />
•� Images can be pulled in report<br />
•� Reports can go to offices<br />
•� Referring physicians get fax<br />
© 2009 OTech Inc. Page 7
OR Solution (Chris/Richard)<br />
•� <strong>PACS</strong>web integrated on boom and 50” wall monitors<br />
•� Nurse accesses information<br />
•� Cath lab and surgical team both work in OR<br />
•� MAClab monitors available<br />
© 2009 OTech Inc. Page 8
Issues<br />
•� Exam dictionaries not consistent<br />
•� Different systems have different record lengths<br />
•� <strong>Cardiology</strong> results posting in RIS<br />
•� More stringent workflow testing and cardiology staff<br />
education: schedule, arrive, begin, completion<br />
•� Downstream systems might be out of sync<br />
(complete status)<br />
•� Mismatches require clean-up and prevent physicians<br />
completing reports<br />
•� Hemodynamics input linked to charging: issues with<br />
lacking ADT<br />
© 2009 OTech Inc. Page 9
Lessons Learned<br />
•� Transition by physicians from dictation to computer<br />
entry difficult<br />
•� High quality reports: use Structured reports with<br />
images included<br />
•� Finish results and fast completion<br />
•� Run discrepancy reports<br />
•� Crystal reporting used to access database<br />
•� Monthly reports about #cases<br />
© 2009 OTech Inc. Page 10
Lessons Learned (cont.)<br />
•� Administrator database access<br />
•� One password for centricity (DMS)<br />
•� Same username for main hospital domain<br />
•� Challenge to have one password (single sign-on)<br />
© 2009 OTech Inc. Page 11
Architecture<br />
•� Single repository<br />
•� Single folder for cardiology and radiology<br />
•� Patient room provides access to images for review<br />
using <strong>PACS</strong>web<br />
© 2009 OTech Inc. Page 12
Final Recommendations<br />
•� Passwords issues<br />
•� Stringent RIS workflow testing<br />
•� Tough to get physicians on board: more training<br />
•� Future web based report confirmations<br />
•� Workflow support is critical<br />
© 2009 OTech Inc. Page 13
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