The Washington Hospital, a community-based not-for-profitacute care facility located 30 miles from Pittsburgh.

SITUATIONThe Washington Hospital, a community-basednot-for-profit acute care facility located 30miles from Pittsburgh, needed to upgrade itscritical information systems, as well as cath labequipment in its Heart and Vascular Center.Knowing their decision would impact thedepartment for years to come, the decisionmakers wanted to select an imaging systemthat would perform both cardiac and vascularexams and integrate easily into the cardiologynetwork to better serve the clinical staff andpatient population. The cardiovascularinformation system (CVIS) solution also neededopen architecture for easy network interface tothe existing hospital infrastructure and to bescalable to accommodate the planned growth.

The Washington Hospital Upgrades Heart and Vascular Center withNew Cath Lab Equipment and Information System

Streamlining workflow with immediate access topatient information and faster report generationwere also very important considerations to thecardiovascular department.

SOLUTIONThe Washington Hospital picked McKessonHorizon which offered both hemodynamics andCVIS on one platform. The hospital thenselected the Toshiba Infinix™ DP-i, a sharedcardiac and vascular system, for its dualpurpose room. The new Infinix DP-i offeredsuperior patient access and coverage forcardiovascular procedures, and increasedpatient throughput and workflow in a singleroom. In addition, Toshiba’s open architecturesuccessfully interfaced with the McKessonHorizon network. Following the positiveexperience working with Toshiba and McKesson,The Washington Hospital acquired two additionalToshiba systems, the Infinix CF-i and the InfinixCC-i, to round out its Heart and Vascular Center.

BENEFITS

• High Quality and Connectivity: The Toshibaand McKesson solution offers an openarchitecture and seamless network integrationfor full access to images at anytime.

• Better Imaging to Improve Patient Care:Toshiba’s Infinix line includes Advanced ImageProcessing (AIP) for improved imaging of all

The Washington Hospital, an acute care facilityserving primarily an elderly patient population,performs approximately 4,300 cardiac andvascular procedures annually. Due to a recentexpansion, The Washington Hospital’s Heart andVascular Center needed to upgrade itsequipment and its critical information systems.

“We wanted to change over to a newhemodynamic and archiving system at the same

time,” explained Dr. John S. Wilson, medicaldirector, Cardiology Services and QualityAssurance, The Washington Hospital. “Thischange was going to impact the entire hospitalincluding nurses, physicians, patients and theinformation technology team, so we needed theprocess to be as seamless as possible.”

In addition to switching to a new cardiovascularinformation system (CVIS), The WashingtonHospital saw an opportunity to replace thecurrent cardiac cath lab with a dual purposesystem that could perform both cardiac andvascular procedures to better serve patients andthe clinical staff. The new system would alsoneed to interface with their current informationsystems vendor. This posed a major challengesince most medical imaging equipment vendorssell “closed” systems that are designed tointerface with their proprietary networks.

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The Washington HospitalC A S E S T U D Y:

Toshiba’s Infinix CF-i SP multi axis, floor mounted diagnosticand interventional cardiac imaging system.

We quickly narrowed oursearch down to Toshiba as thepotential imaging vendorbecause it is the only leadingimaging vendor to offer anopen architecture.

— Kelly Neal,The Washington Hospital

Choosing the Right Cath LabThe Washington Hospital reviewed severalmedical imaging vendors to see which offeredthe dual purpose system they needed whilebeing able to interface with the cardiology ITnetwork.

“We quickly narrowed our search down toToshiba as the potential imaging vendor becauseit is the only leading imaging vendor to offer anopen architecture. Interfacing with our new ITsystem was critical,” explained Kelly Neal,director, Cardiovascular Services, TheWashington Hospital. “To replace our old cardiaccath lab, we selected the Infinix DP-i, a sharedcardiac and vascular cath lab system with twoflat panel detectors to achieve the work of twosystems in just one room.”

The Infinix DP-i addressed two critical areas.First, it provided a system that could increaseasset utilization, by performing both cardiac and

patients, especially bariatric patients, throughincreased resolution in dark areas.

• Automatic Optimization to IncreaseWorkflow: Toshiba’s AIP technology on theInfinix-i systems automatically optimizesimaging during demanding fluoroscopicinterventional procedures and consistentlyprovides high-quality uniform images withouttableside manipulation.

• Complete IT Solution: Unlike manycardiology PACS vendors, McKessonuniquely offers a complete cardiology ITsystem including CPACS, hemodynamics,ECG and reporting on a single platform andsingle database.

peripheral examinations on one system. Thisalso helped support the growing peripheral caseload. Second, clinicians accustomed to usingthe smaller cardiac panel for heart examinationshad this panel immediately available, and thoseaccustom to using the larger panel for lowerextremity or carotid artery examinations had thistype panel immediately available too.

Choosing the Right ITSystemAddressing workflow improvement in thecardiovascular labs was a major considerationwhen selecting a CVIS. “After looking at manyCVIS vendors, McKesson’s HorizonCardiology™ stood apart with its ability to offer acomplete IT designed and driven cardiovascularinformation solution, including hemodynamicsand structured reporting on a single databasesystem,” explained Neal. “We felt McKesson’s ITfocus best served our needs and liked howflexible the company was on customizing asystem to fit our workflow. Most importantly,Horizon Cardiology was expandable forsupporting our echo department and will soonbe upgraded to function as our enterprise ECGmanagement system.”

Another key benefit of the McKesson HorizonCardiology system is its ability to work in tandemwith the Infinix-i system and tie critical multimodality patient information together at oneworkstation. From the workstation, physicians caneasily pull these images into a pre-populatedreport. Utilizing the Infinix-i and Horizon system,the clinician can now create a morecomprehensive and accurate report than previousgeneration systems in considerably less time.

The Time CrunchGiven the large number of patients seen at TheWashington Hospital, there was a tight 90-daytimeline to completely upgrade to the new dualpurpose room. To meet this deadline, Toshibaand McKesson customer service teams workedtogether seamlessly. Each company played akey role in communicating the customerrequirements, attending meetings and workingwith the hospital to install the Infinix quickly andefficiently.

“The deadlines were tight, but Toshiba,McKesson and The Washington Hospital I.T.staff worked together to execute the plan. Whenit was time to go live, everything worked verywell. It truly was plug and play,” said Marcia

Deeb, CVIS coordinator. “Also as thedepartment grew, adding more Toshiba Infinixcath labs and McKesson Horizon workstationsbecame easier.”

New and Improved Heartand Vascular CenterThe open architecture of Toshiba’s Infinix systemand the customer service approach of bothToshiba and McKesson ensured the new dualpurpose room was up and running in 90 days,as well as interfacing with the IT networks. TheWashington Hospital was pleased with theresults.

“Working with Toshiba and McKesson on thedual purpose room was a pleasure. The InfinixDP-i, which has superior patient access andcoverage, has helped increase patient throughputand workflow in a single room,” explained Neal.“Additionally, the Infinix DP-i uses the samesoftware for both cardiac and vascularprocedures, allowing cardiologists to rapidlyswitch the C-arms. This has helped reduce examtime and boost patient throughput as well.”

Following the experience working with Toshibaand McKesson, The Washington Hospitalacquired two additional Toshiba systems, theInfinix CF-i and the Infinix CC-i to replace othercardiac rooms and round out its upgraded Heartand Vascular Center.

The additional Infinix systems helped TheWashington Hospital distribute the patient caseload by supporting new and additional types ofcardiac related cases. The Infinix CC-i, installedin the winter of 2005, is a ceiling-mountedsystem with flexible C-arm positioning. This hasbeen ideal in handling urgent care patientsallowing greater access to the patient andancillary equipment.

C A S E S T U D Y: The Washington Hospital continued

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The Washington Hospital installed the floormounted Infinix CF-i system in the fall of 2007 toperform primarily Electrophysiology (EP)procedures. Due to ceiling installation concerns,this system was the perfect solution as it provideda five axis C-arm that delivers unprecedentedpatient access and the range of motion neededfor EP procedures and pacemaker implants, butin a floor-mounted system.

Shortly after The Washington Hospital installedall three of Toshiba’s Infinix systems, it acquiredToshiba’s Advanced Image Processing (AIP)technology to provide a more uniform display ofimages and enhance the sharpness andcontrast of images during diagnostic andinterventional procedures.

“The image quality offered by Toshiba’s Infinixline is remarkable,” added Dr. Wilson. “The AIPfeature allows us to better image bariatricpatients through increased resolution in darkareas, exhibiting reduced background noise, andimproved device and vessel visualization. All ofthese helps increase workflow and improvepatient care.”

The Washington Hospital has been utilizingToshiba Infinix-i systems along with the HorizonCardiology since summer 2005, and is verydelighted with the results.

“Toshiba and McKesson have become a singlesource solution for The Washington Hospital. Thetwo companies work together impeccably andallow us to take advantage of leading medicalimaging equipment and leading IT networkswithout sacrificing quality or flexibility. They offerthe best of both worlds,” Neal concluded.

Reporting over the image within McKesson Horizon™Cardiology Cath Reporting module.

Left coronary injection acquired using Toshiba’s AIP technology.Multiple stents are clearly visible in this totally occluded leftanterior descending.

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