23 Jan Left to its new devices, Meriter shapes all-digital cardiac hospital
Madison, Wis. – Three years and $30 million later, an all-digital cardiac care hospital has emerged in the heart of Madison, and thanks to healthcare information technology, heart care at Meriter Hospital will never be the same.
Meriter Hospital has had its share of “firsts” in cardiac care, but the heart hospital is the first of its kind in Madison. The new 33,000-square-foot hospital within a hospital, situated on Meriter’s 10th and 11th floor towers, is the culmination of a vision first conceived in 2003.
The end result represents more than just 45 identical private rooms designed to handle every phase of recovery for cardiac patients, more than a design that will allow collaboration among specialists from different disciplines, and more than picturesque views of downtown Madison from the tower.
Nor is it merely about five state-of-the art cardiovascular and electrophysiology procedure labs, direct from elevator to operating room convenience, and a helicopter-landing pad for speedy delivery of patients who don’t have a moment to waste.
The heart hospital is a showcase of the latest in healthcare technology for patients with cardiovascular disease – conditions that affect the heart and the blood vessels that carry blood to and from the heart. The centerpiece of that showcase is an Epic Systems’ electronic medical record system that is the basis of Meriter’s healthcare IT capabilities.
As the hospital moves toward full integration of Epic’s electronic health records in 2009 – the digital record project is about 60 percent complete – patient data is increasingly available on wireless tablets – mobile computers with Cisco infrastructure.
EMR foundation
From that EMR foundation, Meriter has added the latest in technology pieces, the most important of which is integrated digital imaging in the form of Siemens’ Axiom Artis digital cardiac imaging equipment, which comes complete with CT scanners. Unlike last-generation imaging products, this one enables physicians and clinicians to view cardiac and other medical images both inside and outside the hospital, but the benefits really start with integration.
Una Alderman, assistant vice president for cardiovascular services for Meriter, said the time savings that come with being able to examine several imaging modalities in one system – all on one screen at the same time – and the sharper, more detailed images that come with it, reduce the need for other imaging tests. That not only reduces cost, it has improved both physician satisfaction and the hospital’s care mission.
“The digitization of information and images helps us to give more sophisticated care,” Alderman said.
Lisa Kalmerton, who serves as a vascular lead, said the hospital’s intravascular ultrasound lab has transitioned from low-resolution snapshots to higher intensities of 1,024 pixels, which offer finer detail. Instead of seeing only major arteries, she said clinicians now see small side branch vessels and collateral vessels that work their way through the heart.
The level of detail the hospital now enjoys is expected to be chronicled, according to IS manager Rachelle Wendt. Benchmarking mandated by the American College of Cardiology is culled from data already within the system. Thanks to the new imaging and data capabilities, Meriter will be able to interface data from the system into disease-management software from Lumedx (Apollo) in a structured report that will incorporate some of benchmarking data the ACC uses to shape best practices.
Hospitals are required to do so for a variety of procedures and supplies, including balloons used in catheterization to open clogged arteries and patient medications. “There are a variety of different elements the American College of Cardiology has asked us to benchmark,” Wendt said.
Complementing the imaging technology is the unit’s vascular ultrasound equipment, which is typically used with an angiograph and provides different views inside blood vessels. Surgeons can thread a small catheter through blood vessels to view any areas starting to tighten (due to cigarette smoking) or the amount of plaque build-up. Both are capabilities the hospital lacked before.
Taking inventory
Also thanks to new capabilities, the hospital can better manage inventory and save costs. Operations manager Peggy LeMahieu noted that Meriter uses a Pyxis system for inventory control. Each room in the cardiac care unit has large cabinets that house the necessary medical supplies, and the Pysix system allows the hospital to record when supplies are taken out.
“It’s a nice interfacing system that assists in managing supplies by ease of acces within each lab, evaluating supply charges or loss of charges, and assisting in maintaining the appropriate volume,” LeMahieu said. “It also helps more effectively order supplies. As we use items, the system sends a message to our materials management people to order another of the same item.”
The hospital is in the process of smoothing its implementation of the Pysix System, which has been live for six months.
At the same time, wireless communication devices are saving time in a search function – the search for people. A hands-free wireless communication system allows nurses to be notified immediately about their patients’ needs in a quiet environment.
One such device, which is being deployed throughout the hospital, works like a combination pager and telephone, and it is voice activated. To operate, a user simply presses a button and asks the system to find someone, and then it rings that person on his or her device.
According to Alderman, the devices save time by eliminating any need to physically search for people, but time savings aren’t the only benefit. “It eliminates a lot of overhead paging,” LeMahieu said. “It makes the environment a lot calmer and satisfying for our patients.”
PACS
No healthcare unit, especially one that relies heavily on images, would be complete today without a Picture Archiving and Communications System, or PACS. At the moment, the Meriter cardiac unit is in the discovery process with PACS, which soon may replace its current segregated picture-archiving system.
If that discovery process provides the answers Meriter is looking for, it will be phased in starting later this year. The benefit of PACS, as opposed to a “stand-alone” product, is its ability to integrate images from several different modalities in one location.
Today, Meriter’s heart hospital has three different methods of capturing images and they have longer turn-around times, time that is lost when patients could be receiving care. With PACS, all images can be made available throughout the hospital system – in labs, in doctor’s offices, and in remote clinics.
Instead of having doctors go to three different screens or three different places to look at images or information, the system not only puts all patient data on one screen at one time, it provides a much more complete picture of the patients.
“We would have the same clinical experience as they would in the hospital and with less than 24 hours of turn-around time to retrieve information,” said Marsha Wayne, senior systems analyst. “It allows for a better treatment plan and for better follow-up care.”
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