Specialty
Cardiology
Fast Forwarding to Integrated ERA The future will be dominated by digital technologies which will prevent, treat and finally cure the disease without expecting a blockbuster drug to be discovered By Shally Makin
M
ark wouldn’t have been alive today, had the cardiac scanner trial not been conducted by his doctors. The report revealed a major blockage in his coronary arteries and he was operated without any further delay, which saved his life. The digital world has generated amazingly detailed, three-dimensional images through sophisticated computer and IT infrastructure. In 1816, stethoscope was one valuable patient assessment device used to monitor every heart beat. The breath sounds diagnose the condition of heart and provide information regarding the patient’s ventilation-perfusion relationship. However,
since then there has been great development in the medical field. Traditionally, the treatments were performed via face to face evaluation by specialists and trained staff. No one would have imagined that there will be a day when a doctor will be just five minutes away. At the time of cardiac arrest, the immediate aid one needs is the CPR and today the ambulance has got it on wheels for the patient. This way the whole healthcare delivery system is turning towards digital processes. Today the evolution in device technology, increased demands in healthcare system and larger public acceptance of networks and communications has shown a paradigm shift in the sector. Since 1977, with the advent of inter-
ventional cardiology, the cardiologists have received various devices to examine the pace of heart and its functioning. Cardiac treatments nowadays are inclining towards technological innovations. The myriad data elements such as cardiology images, ECG waveforms, lab results, patient histories and hemodynamic monitoring and procedure data are successfully integrated to deliver care. For cardiology, the complications lie in the assimilation of relevant patient data and follow up of patient throughout the gamut of care. Several researches, innovations and devices have proved to provide treatments, which are less invasive, faster and successful. The massive campaign started by the IT infrastructure to implement digital processes and image updating has standardised the process to help meet key goals including trimming costs, optimising quality and increasing efficiency. Cardiology is a very sensitive department which needs effective integration of various information systems. The continuum of cardiac devices purposely needs a ‘DICOM like’ standard, which enables the transfer of images regardless of vendor and hemodynamic equipment such as Sensis, by Siemens Healthcare. This sector is now following the path of radiology with the introduction of a large number of devices using technologies, including capnography (method for patient monitoring of ventilation, pulmonary dead space and blood flow), PADnet, wireless technology in Cardiac
June 2011 < www.ehealthonline.org <
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Specialty telemetry and advanced cardiac monitors like ANSI/AAMI EC13.
“Medtronic’s Care Link Service advanced technology includes a patient monitor that enables patient to ‘connect’ the implanted device in”
Industry presence Global interventional cardiac devices industry forecasts to reach at US $15.7 billion by 2015 at a high CAGR of 9.9 percent during the analysis period 2009-2015. It is estimated that remote monitoring could decrease the 5-year costs of standard device monitoring by US $2100 to US $3000 per patient. The industry is greatly emphasising into incorporating patient data, which includes cath lab reports, echocardiograms and/or vascular services. Then we need to merge the patient’s ancillary services, including cardiopulmonary, rehabilitation and implantable cardioverter defibrillator (ICD) follow-ups to access and potentially input patient data into the CVIS. The cardiovascular information system (CVIS) is the patient and department management tool to facilitate the management services effectively with detailed statistical data and not merely an information capture device. Philips Healthcare has purchased Tomcat’s software, which connects with different clinical information systems and with systems from other vendors. It also provides scheduling, staff and resource management, cost capturing, generation of reports and statistical information. There are presently various products in the market with great success rate; latest products including AirStrip CARDIOLOGY, MUSE Cardiology system by GE Healthcare, CARE cardiology software by i2i solutions and InstaCath by Mediff technologies. The technological revolution has brought a cost effective plan for cardiac treatment and improved delivery of health. Such devices target to avoid routine follow-up visits such as integrity check. A decrease in patient follow-up visits and early identification of problems can lead to a reduction in hospitalisations. Fully automated remote monitoring capabilities will probably be included in all upcoming IECDs, which will shift the emphasis from a device-oriented to a patient-oriented monitoring, allowing a new broader multidisciplinary approach. The devices attached with alerts and transmission of patient information to center and interpretation would ul-
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Milind Shah, Managing Director, India Medtronic
TECHNOLOGY REAPING BENEFITS DOWN THE LANE User friendly interface
Fully automated remote monitoring
Cost effective
Decreased follow up visits
Potential Benefits
Reduce the time for treatment
Proper storage and networking
Reduction in hospitalizations
Increased productivity timately reduce the time for treatment. IT in Cardiology improves patient care, workflow and other key metrics. Implementing a system, such as CVIS, however, is a multi-faceted process that requires hospitals to analyse particularly store and network. Designing the storage system requires close collaboration between cardiac imaging and IT.
> www.ehealthonline.org > June 2011
One of the most advantageous aspects of connectivity in cardiac telemetry is the videoconferencing and echocardiography equipment which enables real-time transmission of echocardiograms from the remote center to the cardiologist at the referral center. Milind Shah, Managing Director, India Medtronic says “Medtronic’s Care Link Service, remote