The Essence of an Advisory Team in Cardiovascular Image and Information Management System Conversions

As healthcare organizations expand their cardiovascular imaging services, similarly, capital investment dollars also increase exponentially on information system conversions, making many a chief financial officer and chief informational officer worry about uncertain return-on-investments scenarios. While some may view expansion as strategically necessary to remain competitive, others may inherently view it as a essential to providing better quality care. Regardless of philosophical mindset, investing substantial funds in a cardiovascular image and information management system (CIIMS) is a venture that can easily offset the much higher costs associated with the provisions of cardiac services. Form a Team and Look Ahead As the healthcare imaging industry continues to rapidly grow and evolve, CIIMS conversions require careful analysis and planning so that every dollar spent has a high yield in return-on-investment. To effectively complete these conversions, healthcare organizations should form an advisory team of clinicians, managers and technologists from several key departments: information systems, cardiology, preferably someone with echocardiography experience who is secure in their knowledge of computers, and someone from materials management. Once the advisory team has been formed, the team should outline a futuristic roadmap for the cardiovascular department that parallels the organization’s vision. In the early stages of planning, the team should focus on the robustness of the organization’s existing information network infrastructure. The team must ascertain the speed and the capability to transmit signals that are 250 MB or more across the network. Having a 1GB line versus a 0.5 GB size network backbone is somewhat analogous to having your hospital banked in the Panama Canal as opposed to being banked on a stream. Therefore, before bringing the Queen Mary to your docking area, you have to first determine if it will dock or not. It’s the same principle with networks, and if the hospital’s backbone network needs a boost in transmission speed and in memory capacity, this should be addressed immediately. Assess Following the decision to upgrade or replace the organization’s network, the team should assess the current status of the ultrasound equipment and determine the capability to acquire, store, and transmit DICOM (digital imaging and communications in medicine)-formatted imaging clips that vary in memory capacity from 250 MB to 500 MB per imaging procedure. If the ultrasound carts are relatively old, purchasing new carts bundled in a package deal that includes a CIIMS consisting of several image-viewing workstations, interface solutions, imaging and storage servers should be strongly considered. However, if bundling is not an option, ultrasound carts with superior imaging quality from vendor “A” should easily interface with a CIIMS that is highly intuitive and user-friendly from vendor “B.” Regardless of the path taken, the ultimate goal should be to assure that the ultrasound carts are capable of integrating and communicating smoothly with the CIIMS and the hospital information system (HIS) so that patient’s information and images flow in and out throughout the enterprise. Must-Haves Of paramount importance when considering upgrading or purchasing a state-of-the-art CIIMS is the long-term growth potential of its applications and storage capacity. The architecture and the platform of the system considered should be flexible, upgradeable and robust to accommodate imaging upgrades such as 3-D echocardiography technology or one that is capable of performing sophisticated reconstruction imaging functions. With regards to robustness, if pediatric services are performed, storage capacity based on storage time limits for adults and pediatrics patients should be strongly considered. For this purpose, a SAN (storage area networks) solution with at least 20 TB of storage capacity and one that separates the storage of each group (25 years for pediatric patients and 7 years for adults) should be considered. This solution can reduce storage and archiving costs significantly. Location, Location As last items on the list, the team should decide on the location to place the storage and archiving servers, and decide how the connection will take place with the ultrasound carts. The preferred location is distant from the cardiovascular department, preferably in the information services department that complies with strict HIPAA regulations. The preferred and the most economical method to link the ultrasound carts with the servers should be via an Ethernet data line. From this point on, the loop closes and the initial benefits of solid analysis and planning by the advisory team become evident: the implementation process proceeds flawlessly, productivity and workflow improve, and image-viewing accuracy increases, enabling cardiologists make better diagnostic decisions, resulting in better patient care outcomes. James Calero can be contacted at jamesdoc@msn.com

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