A customer interview with Dr Glennon, Walsgrave Hospital, about GE Healthcare’s Centricity Cardiology IT solution.

1. The Walsgrave hospital has successfully implemented a Centricity Cardiology IT solution. What were the key considerations behind this development?

The key considerations were ease of use, reliability, integration with other system components and existing ICT networks, adaptability for our workflow, and availability of good technical support.

2. Why did you decide to partner with GE Healthcare?

The choice was difficult because there were so many seemingly good solutions available and it was hard at the time to find any of the products being used in a ‘real’ busy working environment. GE was our PFI partner and we had already made the decision to purchase GE imaging equipment and haemodynamic package. It was therefore natural to choose the GE IT solution, and this is a decision that we have not regretted.

3. How did the solution change the cardiologist’s work environment?

Previously the technician would enter patient and procedural data into a computer that produced a printout. However, there was no way of accessing these data electronically for further use or analysis. After the procedure the doctor would write in the notes and duplicate much of the data entry on a different database for our national audit returns. A letter would then be dictated which would take on average two weeks to be typed. Another week or two would pass before the letter was checked and signed, and then it would be posted to the general practitioner. Angiographic X-ray images would be burned to a CD that would be stored on a shelf. This would sometimes go missing.

Now the technician enters the patient hospital number in Centricity, and pressing return populates the patient demographic data automatically from the hospital admin system via an HL7 link. Details of examinations performed and equipment used are recorded during the procedure in MacLab, and at the end of the procedure are quickly and easily exported to Centricity for use in the doctor’s report. The doctor opens the study record in Centricity and all the necessary data are available for review (including the associated angiographic images which are automatically opened).

A report is created by entering data in just five fields, the remaining fields being populated by the technician-entered data. This report is printed and signed by the doctor as the definitive record – it is no longer necessary to write in the notes for routine cases. The report is simultaneously exported to the hospital intranet where it is instantly available for GPs and other hospital doctors. It is also exported in RTF format to a shared drive where it can be accessed by the medical secretary and form the core of the final discharge summary. The images are exported to a central image vault and can be accessed immediately by multiple users via a web-viewer.

The overall effect has been to reduce the time for communication of results from weeks to minutes. There is significantly less duplication of data entry, and the data are used more efficiently to help workflow. We also have an accurate procedural database that can be analysed for audit or research. Our national audit data returns are made much easier by use of Centricity.

4. How does the solution help to meet the challenges in healthcare (time and cost pressure, patient safety, high quality care, lack of resources, etc.)?

The timesavings are undoubtedly the most dramatic benefit, and this particularly reduces administrative costs. Ease of access to the results saves everyone time and improves patient safety. Patients particularly like to receive a copy of their report at the time of the procedure, which was not possible before. Quality of care is still dependent on the quality of information entered, and it is particularly important to ensure the report is as accurate and complete as possible.

Amended reports can easily be generated, and only the most recent report is available on the hospital intranet. This allows senior review and amendment of reports if necessary at the end of the day. The ease of analysis and audit helps us identify clinical problems early so that corrective action can be taken.

5. Healthcare enterprises have to focus more than ever on prevention of diseases. How can modern IT solutions contribute to early diagnoses?

Rapid and accurate communication can ensure that doctors have all the information required to put full preventive measures in place quickly. In cardiology this relates to adjustment of medication in the light of angiographic findings. Modern IT also allows early diagnosis and treatment to prevent complications developing. Centricity is a central part of our Rapid Access Chest Pain Clinic where patients with newly diagnosed heart conditions are seen within two weeks of referral.

6. What are the future plans and the vision for the Walsgrave hospital and your cardiology department?

We believe that good data are crucial to ensure the best quality care for our patients. To be accurate, these data need to be entered by front line clinical staff as they work. In order for this to be acceptable, the data must be used in some way to make things easier for the staff. This has been the case in the cardiac catheter laboratory and the Rapid Access Chest Pain Clinic, but we have ambitious plans for other areas. These include preoperative assessment on the ward or in clinic, patient care on the Coronary Care Unit, pacing and arrhythmia.

We are also about to display the Centricity scheduler on a plasma screen outside the catheter laboratory to act as a ‘Departure Board’ so that staff can quickly identify which patients have been done and which are next. The scheduler will also be available on the ward so that nursing staff will know when to begin preparing a patient for their procedure.

We are working with GE to map identical fields between our operational datasets and our national audit datasets, so that data only need to be entered once.