cardiology pacs integration the heart hospital, baylor … · · 2018-03-06cardiology pacs...
TRANSCRIPT
Cardiology PACS Integration The Heart Hospital, Baylor Plano
Herman Oosterwijk, OTech, Inc.
Christopher J. Oropeza
Richard Sanders
Lori Crissup
© 2009 OTech Inc.
Provided by ITN and OTech Inc.
Sponsored by GE Medical Systems
© 2009 OTech Inc. Page 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 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 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 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 6
THE HEART HOSPITAL Baylor Plano
Current RISIC/ Enterprise Imaging
Interface and Image Transfer
EP Labs x4 CVIS/DMS Reporting
Workstations
x3
Cath Labs x4 CVIS/DMS Reporting
Workstations
x4
OR Suitesx4
Sequoia’s x4 Cath/EP Lab
x1
Ord
ers In O
RM
^001
Resu
lts In O
RU
^R
01
ConnectR Hl7 Engine
RISIC
Resu
lts OR
U^R
01
PACS
Baylor Clover
Leaf HL7 Engine
Ord
ers In O
RR
^002
Siemens Sensation 64
Siemens E-Cam
Kodak CR825
Siemens Sequoia x3
DICOM Image Send
DICOM Modality Work List
QDX Hl7 Engine
CVIS/DMS DICOM Image Send
DICOM Image Send
DICOM Image Send Radiology Modalities
Diagnostic WS
RA1000 Power Scribe
Integration Diagnostic WS x2
CVIS/DMS
Reporting Workstations
Stress lab x1 Card RR x1
TeraRecon & Power
Scribe For Cardiologist
PACS Tech
Workstation x7
DIC
OM
Modality
Work
list
GE Centricity
Enterprise
AD
T In
AD
T In
Oders O
ut O
RM
001
PATCOM SoftMed
AD
T In
Charg
es In D
FT
AD
T In
Resu
lts In O
RU
^R
01
Resu
lts OB
OR
U^R
O1
Charg
es Out D
FT
Orders Out ORR^002
Orders In ORM^001
ADT OB
Results In ORU^R01
Schedule\Exam Schedule\Exam
Ord
ers In O
RM
^001
Created by: Christopher J. Oropeza
Rev. A: 01/31/2009
DICOM Modality Work list
DIC
OM
Modality
Work
list
AD
T In
Charges OB
GE AMX DR
Portable
© 2009 OTech Inc. Page 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 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 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 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 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 12
Architecture
• Single repository
• Single folder for cardiology and radiology
• Patient room provides access to images for review using PACSweb