RICHMOND, VA – Cardiology IT systems can be the source of frustration for many a hospital IT chief and especially for the end users.

But, it doesn’t have to be so, says Jennifer Gentry, system analyst at Bon Secours Virginia Health System, which has a GE enterprise cardiovascular information system (CVIS) integrated into its Epic electronic health record system across its four locations in Richmond and its three sites in Hampton Roads – the Norfolk, Virginia Beach metropolitan area.

“Client satisfaction continues to trend downward industry-wide as vendors fail to deliver on integration, functionality and service expectations,” said KLAS Research Director Ben Brown when KLAS released his report on the cardiology IT market in June 2010. The frustrations were mounting, he said, and nearly 1 in 3 CVIS system users were thinking about replacing their systems.

That’s exactly what Bon Secours did. Or, more accurately, Bon Secours began replacing its disparate cardio systems – including some with companies going out of business – with a single integrated system from GE Healthcare in 2009. Around the same time the health network rolled out a new Epic EMR with the goal to have all sites using the same technology.

Daniel Salzberg, administrative director of applications for Bon Secours Virginia, led the implementation of the new CVIS system. He remembers the individual silos of technology in place before the switch, with four separate document management systems (DMS) at one site.

“None of our CVIS systems talked with each other,” Salzberg recalls. “I don’t believe they had interfaces – or not all of them did.”

Today it’s a different story: “Our workflow, structured data in the GE Mac Lab system, and structured reporting in the GE DMS system are our strong suits,” Gentry says.

“Now we’re fully integrated across the board with both invasive and non-invasive aspects of the cardiovascular information system,” Salzberg says. “The concerns of not having all the components to create a CVIS solution – they are addressable. I believe we’ve done an excellent job of reaching the consolidated and integrated solution.”

Marc R. Katz MD, chief medical officer of Bon Secours Heart & Vascular Institute calls the CVIS setup “amazing.”

“One particular afternoon, while seeing patients in my office I was able to discuss clinical situations with cardiologists at two different facilities in Central Virginia, he says, then a third in Hampton Roads. During each interaction I was able to view the patient studies, one while the patient was still on the table. This system allows us the advantages of co-location while being spread statewide. A huge advantage for rapid integrated patient care."

Omar Sunna, GE Healthcare’s marketing director for CVIT, notes the Bon Secours project was a complex one, reaching across multiple facilities and across geographic areas.

“You really need the time, the planning, the dedication, the consistent leadership and the dedication of resources to be able to work and accomplish what you want,” he says. “In my mind that’s one of the key successes at Bon Secours Health System versus other organizations. Understanding your workflow, understanding your process, realizing what needs to be different is what Daniel and his team have done.”

Salzberg says he can’t put an exact price tag on the project, and he adds the return on investment is inexact because much of the return includes achieving better patient care.

However Bon Secours’ cardiology system analyst Jason Smith tenders an example that highlights both added functionality and benefit to the clinician and the patient. “It’s as simple as having hyperlinks in the electronic medical record system that go directly to patient images in the PACS imaging system, having an audit trail of who looked at what images. And maintaining all the chart privacy controls in the EMR system.”

“A physician can log into a patient’s chart and there’s a link right there to that patient’s echo images,” Smith says. “We’ve actually seen they’ve been using that data and looking at images more often than before that integration because it’s so much easier now.”

Document management and structured reporting have eliminated the need for transcription, Smith adds. “There’s a huge cost savings there.”

“From the patient perspective,” says Gentry, “they’re given their diagnosis faster because the physician does not have to wait for a transcribed report, which can sometimes take up to two or three days.” With the DMS structured reporting, she says, the physician is able to more quickly produce his results and communicate that to the patient, and the patient’s family.”

Smith’s advice to others who are facing similar issues that Bon Secours experienced with its jumble of systems? “You have to think big,” he says. “When you see a CVIS need, it is tempting to quickly purchase a specific solution. Say you need to cut transcription costs; you can implement a simple echo reporting system in a matter of months. Repeat this process a few times, and you end up with disparate systems in your EKG, echo, cath, and nuclear departments.”