Understanding the benefits of single-database cardiology

Hello, everybody, and thank you for joining us

today. My name is Dave Warner on the editor

of Diagnostic and Interventional Cardiology magazine,

on behalf of D. I. C. In our sponsor,

Change Healthcare would like to welcome everybody to.

Today's presentation

is titled Understanding the Benefits of

Single Database Cardiology.

To improve efficiencies in your cardiology department,

you need technology to streamline work floats,

reduce redundant data entry

and balance workloads while keeping costs under

control by integrating your e

h r in DNA. A single database

cardiology solution can provide efficient

data entry at a point of care, plus

increased data aggregation and make

the care team collaboration easier.

This webinar will outline how health care providers

can utilize a single database cardiology solutions

to create a complete, unified cardiovascular

record that supports your patient care initiatives.

We will discuss best practices for leveraging

your major IT investments,

addressing challenges in the registry

requirement

in also sharing imaging data all

within a single system.

We have three speakers today.

Ellen McVicker is the cardiovascular

information systems coordinator at Washington Health

Systems in Washington, Pennsylvania. He

joined Washington's team in 2006

as a staff nurse and cardio in the cardiac catheterization

lab. In 2017, he became a CVS

coordinator and he manages the cardiac

EMR, which includes cardiac cath

electrophysiology, peripheral vascular

structural heart echo nuclear

medicine, peripheral vascular ultrasound, halter,

E. C. G.

In a CD modalities

or gardening is the executive director

for product management of Change. Healthcare, Aureus

and Experience is experience in business

product in People Leadership, with over

12 years of experience in building new businesses

and innovative innovative products and

in leading product management groups.

He leads a group of 15 product directors,

senior product managers and product managers.

He receives all global product strategy

roadmap management, BD go

to market in execution activities

across all product lines and portfolios for

change Healthcare. Cardiology

Kathy Jennings is the director of

cardiology for WHS

Washington Hospital. Kathy has been

a registered nurse for the past 38 years.

She has worked in multiple roles during

her nursing career.

She worked in education for

10 years. She taught at Waynesburg

University. In there are N DS

and Track, and as director

of cardiology, she is responsible for the cardiac

catheterization lab, cardiac diagnostics

and cardiac rehab.

We're going to get started with the presentation in just a second,

but a little housekeeping. First, you'll notice

on your viewer that you have the ability to ask questions.

We encourage you to ask questions, and then we'll

try to answer as many of these is, we can't at the end of the presentation

based on kind availability,

any questions that did not get answered at that time,

we will answer offline.

With that, I'd like to turn things over to order to a big

in the presentation.

Okay, it

Thank you, Dave. So hello, everyone.

We wanted to start off, but just quickly

summarizing, Um um,

presenting who we are. Eso Cathy,

Um, can you please provide a summary

of the history of your partnership

with change out there?

Sure. So, um,

we were a complete

paper system back in the

early 2000, and we wanted to go on

a venture of becoming automated.

So our vision and goals as

the Washington health system was to

remain a locally governor

um, facility and

still have great patient care. So

we looked around and we found change healthcare

in 2000 and six that had similar

goals that we had, uh, they had

innovated ideas, and they wanted

to put together a robust system. So we

joined together back in 2000 and

six. And, um,

we have been building, ah, high

performing cardiovascular service

from that point to this point, and

it's pretty much complete now. So

we started out very small. We

started out with our

him a dynamic system.

Um, and then we added different

modules as, um, we

progressed. And so we

have added, um,

the point of care use

echo news, med

E k g

peripheral vascular.

So as things become available, if

it's something we do in our facility,

we grow the business.

Thank you, Kathy. And I'll just add

to that that from our perspective here change healthcare.

Washington health is very

valued partner, and they have that unique

perspective stemming from what Kathy

just described

of being with us, uh, going

back quite a bit,

um, where they were really with us as

we grew our portfolio s Cathy

said today they have, they have everything they

need. But as we added more modules that

we deepened our portfolio as we made these

strategic development investment decisions

like, um, single database architectures,

which we're going to talk about,

um,

through the ultimate desire to bring to

value to address these complex cardiovascular

work flows.

Um, And for that, um,

that the feedback

and the inside of customers and partners

like Washington health is obviously very

valuable.

Um, for that journey.

So, um, today we're going

to basically try and capture

a complete story for,

uh, about cardiovascular care.

We're gonna focus on three sections,

starting with unique value of often

MDM cardiovascular solution on that

single database architectures.

We're going to talk about streamlining

and best practices, um, for

registry submissions and also reimbursements

And how that is all tied into,

um, documentation, capabilities

and work flows. We're gonna sign

off with the last section

before we go to Q and A to talk about how we optimize,

um,

operations, efficiency and workflow.

Um, through data, they're driven decisions

stemming from robust analytic solution.

So, um, starting with her

first section,

um,

I'll first just cover, um,

cardiovascular work so that everybody

on this call and most of

our listeners are very familiar with

obviously very complex multiple stakeholders.

Very large ecosystem.

Uh, a lot of data

on Daz. We try toe first

math. You know, what are the challenges and having

separate systems or silence components?

Um, we see a real impact.

Ah, potential impact of

such challenges to workflow efficiency.

To be able to consume data,

um, to provide proper

care And this eventually all flows to,

you know, to operational assistant efficiency

on. And as I said, um, you know, affecting

even patient care.

And those challenges, um, could be in a

variety of areas. But we know that some

of them, um, here now, about

when you have all these works, all these all these different

modules,

um, you're bound to have the more

separated that are. You're bound to have cumbersome

interfaces. Um, the more interfaces

you have or may break or may not be

completely effective. Um,

you may have issues with accessing data

of accessing all the data you need at any point

at any place at any time.

Um, redundant documentation.

Duplication of data was error since

it entered by the spirit modules for different

style of modules in different places and different

databases.

Um, it's also challenging to

scale.

Um,

as you look, you know, to expand

either single facility or add additional facilities

Onda off course

with. If all the data flow is

not perfect and it's not efficient

than the data, you would eventually

have to query to analyze,

um, to drive insights from that

will also be compromised.

So, Kathy Allen, I want to just stop

here for a second and just

to get your thoughts. Um, if

you agree that, um

that you know what? What? What? I just went over

here. Um, that's really, um

I'm capture. What did you also see as

a key challenges?

Um, when you do have silo system

so you don't have a single unified platform,

Would you agree? Um to what?

We What? I went over here.

I agree. Um,

you know, if you have siloed systems,

you know, your physicians would, you know, may

have to look in one place for,

um, e k g one system

for an echo.

Um, you know, they're doing their calf,

um, documentation and reporting in

another system. Um, whereas,

um,

at our facility,

um, that interventional

cardiologists can sit down

and and with it with one log

in, can log into the system and

look at every study that that,

um, patient that he has taken care

of has had,

whether it be an e k g echo.

Um, it's all there, um,

at his fingertips toe. Look,

um, and Thio to read reports,

um, they could do their reports and all that

same system.

So if that same cardiologists is reading

echoes, he can read that ECOWAS. Well,

um,

the e k g peripheral vascular

study. Uh, E p. Whatever

he needs to read is all there at his fingers.

Thanks, Allen. Yeah, And I think, and

I think I mean, because of a long

history, you're also in a unique position to know that

because because athlete develop more and more modules

and created that single ecosystem that

single platform than you able to really realize

that value just talked about,

um, So going over Tiu

the next slide just to present you know

what I mean? What is the current?

What is the solution offering we're talking

about S. So if you look at this

graphic on the right side, um,

you can see the different

the you know, the very broad solution

and the different areas for structure reporting.

Obviously thinking of dynamics and refugee as

Alan Kathy mentioned, um, toe

obviously cardiology packs um,

and and administration layers for analytics,

for charges for inventory.

Um, and when we say maybe

stop for a second and say when we say single

database architectures, I mean, first of

all, it is an architectural right,

And what we're going to talk about here is not about the architecture.

Of course, it's really about the value.

But the value that comes from the work flows from

the output from the efficiencies from

staff satisfaction and enhance patient care

that could be better promoted

on top of this underlying

architecture. Er,

um, And now they say we have all of these cardiovascular

modules they just reviewed. I'm developed

around a single database in a modular way.

Um, so so they can

be used partially or all of them together.

Of course, all of them developed,

um, on that single database

on, and this also gives you that single

point of contact with your HR

or EMR. However, you choose to call

it Andrea Lee, create that

single cardiovascular record,

right? Because any cardiovascular solution

is just part of a bigger ecosystem

of your tomorrow. If your DNA of your enterprise

viewer, you need all of those to work seamlessly,

um, together to get that single cardiovascular

record.

Um, so

having that single focal point

for interoperability also

promotes that.

And when we look at some of these advantages over here

on the left for single for a

single database for single cardiovascular

database architectures,

um, we usually talk about political work

flows, but how this facilities

improved operational efficiency in patient care

products from a single vendor, of course, designed

to work together in a single database and

a single point of data entry work

flow. Which means, you know, you only put

whatever piece of data you put it in one

place one time, and it flows

wherever it needs to go. Even if its cross module

cross, um, cross domain

within cardiovascular care,

um, and also enhance the consumption of data,

as Alan just briefly described in the

previous slide off having that

ultimate access everywhere

within your facility or maybe within several

facilities working off that database. And

one good example for this clinical work clothes is,

um is on the cath lab work flow,

because the cath lab works also have different modules

used by different stakeholders.

Um

um, for your pre procedure

holding your just charging for your nurse charting for your

human dynamics for your Catholic destructive

reporting for the physician, for charges

for analytics, for interrupt,

um, and so on And, of course, images themselves.

And when you have all of those modules within

that complex,

um, invasive lab workflow, working seamlessly

together, built on that single, um

database and seamlessly

interfacing with your EMR ringing

in data and pushing out data, um,

then you have that full cardiovascular

workflow. Um, and this promotes

staff. Satisfaction also promotes

no entering of data. Like I said,

single point of data entry work flow.

Now, the second point here talks about reducing

I t overhead and improving operational efficiency.

Um, obviously single backhand

tiu men maintain, um,

increasing robustness and interrupt between,

um, the cardiology model because

you know, that same database. So,

um, it's faster and easier maintenance.

Um, improving your control over cybersecurity

and it's very easy to plug and play if you grow

cardiology portfolio and you add module

or modules

Now, the third point here. Obviously,

it's not in order of importance, but it's to me

maybe one of the important ones about

maximizing your hrm our

investment

so regardless of the m R vendor that you

currently have.

This

provides you with a single point

of connectivity and interoperability

with your EMR ecosystems.

So whatever modules you choose to use

within within, you know,

the change healthcare cardiology component.

Um, you have that flexibility.

Um um um, to

choose what you want. Person works for person.

Um, our work. So you want to utilize

um and then making and

making sure that you have that seamless interoperability,

Um, with your EMR vendor.

And this could be an EMR driven workflow change,

healthcare driven, workflow

and unexamined for that,

I mean, if you're using, for example, epic as

your EMR and you're choosing to use

work was epic. You did as you're reporting

solution,

then that doesn't change

the underlying architecture right on that

same single database architectures

that provides you the ability to choose

full change healthcare driven works. Those with

all of these modules and still having

that single point of focal point with your

EMR. Whichever one it is

or for the epic example

Again, Just an example. If you're using

after Cupid, you choose the modules

you want. You want to utilize within change

healthcare in this case, um, probably

cardiology tax. He would dynamics,

maybe e c g.

You will be doing your reporting an epic,

and you still have all those cardiology

modules working on the single our database

and being able to inter up with

epic and epic Cupid, creating those seamless

work flows.

And that's really that's power of that unified

layer is a single point of interoperability

with your year mark, um, which

is that that large investment that you

made and then the last two points

here talk about being expansion ready?

So if you consolidated, you have additional facilities.

When you have that single, that single

focal point, that single architectural

behind the scenes, it's very easy to basically

plug and play and add additional facilities.

Um, just set them up in the system

and then they'll have access, um, to

the different modules, um um

within, um, within the cardiology

solution and finally, data

insights again, one of the very important

points which really ties in all of this, and

we'll have a way I won't talk too much about We have

a separate section about that.

But all these work flows all these

efficiencies, all the

promotion of structured data entry

all flows in eventually

into data. Getting into that

database that you can get meaningful

insight out of and and,

you know, make your operations better and enhance

your productivity.

Now, I did wanna stop here, Allen. And,

um, for a quick question, um,

relating to what? I just went over. Um,

are there? I mean, obviously, Do you

agree? You know, being advantages of the single

cardio after workflow. And are there

any, um,

is there any example for any of these

that you can give of how How you really

saw this value come into play?

Um, in Washington?

Yes. And 2017.

We implemented, um,

two news sites. We had,

uh, we acquired a

second facility for ah,

hospital.

Um, that has cardiovascular services.

Um, cardiology services there.

Um, and what we found

was,

you know, once we created the, uh,

the site within the management console

within change healthcare.

Um,

we were able to get those exams

that were done at the second facility.

Um

t o

the physician had access to them, so they

So if a patient had an echo or

in any kg at the

our satellite facility. They

we're able to access that

within change healthcare under that

patient

under that patient's record.

Um, so we have a lot of patients

that come up from that second facility

to have a cath procedure or

other procedures, and the physicians can access

that as well.

Um, a second example. Waas the

other site that we had, um, initiated

waas

the the cardiology office.

Um,

they do a lot of peripheral vascular

ultrasound studies in there.

Um, and so we were able

to, um,

set it up very easily

again, An MMC.

Um,

so that those peripheral vascular studies

also,

um, are imported into

the change health health care product and

the physician's report on them in there.

A swell. So, uh,

that made two very large projects.

Uh, that portion of it. Ah, lot easier

to accomplish.

Thanks, Allen. And keeping

all that same thread. Cathy, um,

can you maybe expand a bit on some

of these benefits? Um,

through that single database workflow

as the experience them around workflow

and access to data.

Sure. So, basically, orient

Alan summarized some of the stuff. Very

Wow. Um, so basically,

if I'm a provider or a clinician,

Aiken sit down at Eddie

Computer in the hospital, whether

it be at the doctor's office or

25 miles down the road or

here in the main building, and

I can pull up my patient and I could

see their whole cardiovascular story.

I can get there

E k G that they got

and maybe it was abnormal.

And then we moved on to stress test.

We could pull up their stress results.

And, of course, with the stress test, you

usually buy yourself an echo, and then

I have my echo results.

If they have to go into the cath lab,

then I can pull

up the path, report previously

and look and see what they had before

as they come back for another study

so they can look at it all

in one big

picture at one spot in the facility,

and they could make their decisions for

the patient quicker.

The data gets sent out

as soon as the provider signs

the report, whether it's an e, k g,

echo or calf,

and that

seamlessly Faust to the

M R.

Here in house, and it

gets sent to the doctor's offices

well so it gets sent to referring

and

ordering physicians at the immediate

time of signature.

The other nice thing is with a single

database is there's no dictation

anymore. The doctors basically,

um, call out

things in the cath lab and

the nurses populate for the doctor,

and the doctor sits down. It might

take him two or three minutes to sign

the report, and then we

have it completely done. Thea.

Other nice thing is as it signed,

it goes straight to our floors.

And so the nurses that are receiving

our patients post op know exactly

what we did

before they even get to the floor.

Um, their meds follow them a swell.

So when they're giving their meds, they can see

what we gave in the cath lab. So there's

not any duplication of medications.

Um, this has become a very complete, robust

system for us,

and, um,

the doctors have ideas

how to improve it. And so

basically, if there we want changes,

we consume, it changes.

So what we have today may not

be the end results in another

year.

So as things growing cardiology,

so does this system.

Thanks, Cathy. I mean, thanks so much

for that. I think you have much, Much

better. Um, then I tried to describe

it. Really? Painting that picture off?

I mean, obviously, from your perspective

of the actual you know, stakeholders and users

using the system,

um, of, of, of what the power

is of having all that data, although

modules each one by itself,

um, being very I mean,

very good and so on, but only

when they all work seamlessly together.

And you have the different stakeholders, the different

people from nurses in the text,

Um, and positions, of course. And administrators,

Each one putting in the data. They need to put

where they need to put it and have that data

pop up where someone else needs to use

it and having that seamless access,

I think that's that's really paint. You know, the

best picture of really the value.

Um, um

um, that, you know, we're trying to, you know, to

convey during this discussion.

So thank you for that.

Um,

and Kathy did, um,

regarding specifically regarding,

um, inventory or point of used inventory

or there, Um, any specific

benefits? Um um

um, specifically in that area.

How we manage inventory?

Yes. Um, it's inventory is very

nice because you can set your

par level.

So at, um, Men's

and Max is

so if I have seven on hand

and my max is 10

and my men is

to it won't reorder until

where I said it.

So basically, um, it

helps Ah lot with our

inventory.

We used to just put pieces

of paper in each room and put

stickers on it. At the end of the day, we would collect

it and try to order it. Now

everything just gets

scanned in in the back, in the

calf off, and it goes to

an inventory batch that we get.

And at two o'clock in the afternoon, we print

that out, and the stuff

that needs to be overnighted gets

ordered then and then.

The stuff that we can wait on

goes into the cycle and gets

orders at the men's. And Max is

there is

human involvement, So anytime

there's human involvement, there could be human

error. But there's less human error

with the scanning off the product

and having the product available this way,

then manual,

uh, the other thing with third party vendors,

we can entertain them a zoo well,

and they can help us,

um, also get information out

of our system. And, Alan, will

labra

elaborate on that a little bit later.

Um,

so we're very pleased with the

point of use inventory.

Thank you, Kathy.

Um, so

thank you. And I think that wraps up that first

section. And, um,

now we're going to move on to our next sex,

um, section and And this this section, we want

to review

basically some of the challenges and best practices

that relate to documentation

being able, digging in a little bit deeper,

um, being able to keep accurate and

up to date records, um, through

the clinical works. Well, of course.

Um, obviously, in order to be in

compliance, you need to gather all the registry

data accurately. Make sure you're

on top of any changes to the requirement that

they, you know,

come in.

And you need to staff to

actually put the data in there.

Of course,

if that doesn't happen, then you don't have the field.

Um I mean, you don't have the field. You

cannot get the staff to adhere into data

at all are accurate. E. Then you have misalignments.

Um, this all off threatens your

compliance for registries.

Um, and it's exactly the same

thing for reimbursement, right? So

I mean, those the same, the same

needs and those same issues or challenges

can affect, you know? And if you don't have that

documentation perfectly aligned,

I'm an accurate and filled

out. Um, that can

negatively impact your reimbursement.

So what we wanted to discuss in this section

is really how can how can product,

you know, from the way it's built

from the architectural product to how it's used,

um, to best practices, um,

that the staff brings in how all

of that together

helps overcome these challenges.

Um, and basically allowed to

have, um,

better, better compliance

and accuracy.

And, um, and content in

your reports.

So

moving over

to the next slide, Alan,

I'm going to be turning to you

and asking you how does,

um, how does you know the product,

you know, way have in place right now?

How does this help you gather the registry

requirements?

Um, and compliance. I mean, sort of

describing that the work that I started from

of, uh, even if we just look at

registry or the same for reimbursement,

how does the current workflow.

Um, and, you know, help

you

or help your staff, uh,

make sure that data goes into the system, and

eventually it's there, um, onwards

to registry compliance and reimbursement.

So I will use the

Catholic

example. Um,

because that seems to be where most of

our registries are. Our patient

documentation begins, um,

in our pretty post holding area,

when the patient gets there, um,

the staff opens the pre procedure,

um,

module on the hack station

or the holding area charging station,

and that's where the documentation

begins.

Um,

and

basically, our our modules

are set up to mirror our

our registries eso

that when they start documenting,

um, basically go

through the tabs and they're filling out the

data family medical history,

for example.

Um, previous cast

that sort of thing. And so when they

document all of their pre post, um,

information, once the patient goes

to the cap,

they closed that

the patient out on the

on the hack station and the patient

goes to the cath lab.

And

yeah, they opened that procedure that patient

up again in the on the chemo station,

and the documentation continues, they

do the procedure again. There's

You know, all of our,

um, information on

the on the on

the gooey or the graphic user

interface mimics our registry,

so they work their way through that

as they're doing the procedure.

Um,

and

once the physician again, like Kathy

said earlier, once a Z physicians

doing the cap, the more information that

they give the monitor ners assed

faras lesions. Um,

any type of information that they want.

The monitor person enters that,

and it seamlessly is going to the report

as they're putting it in

s so that when the physicians sits down,

they put their summer in and recommendations.

And once they sign that

report,

all of that information that was put in all

of that registry information

is, uh, sent out via

interface to,

um

we used to run to

manage our registries.

Um, and once that, um,

information is it sent a cedar

on, and then we have a quality assurance

nurse that will,

um,

double check that information. I really double

check, but just verify that there's nothing

missing. And then she will submit

that to N c d. R.

When the, um

not the appropriate deadline,

but what we have found is

that there are, um,

requirements for these registries,

that there's information that needs to

be on the physician's report.

Um, So what we've done is

on the

gooey section or the graphic user interface?

Like I said, for the position,

we have added any required

documentation. Um,

for example, E

p devices.

Um,

optimum medical therapy is

a requirement. Needs to be on the report that

the patient they had attempted

to

obtain the optimum level

of medications.

Um, the physician has to address

that before they consign their report.

So

and there's a section there that,

um, that they have to address. And then if

they weren't able to meet it,

um, why weren't they able to meet?

And all of that populate

the physician reports

eso that, uh, we will

meet the requirements because,

as we know

as faras, the registries reimbursement

is all tied to that.

Ah, and we have seen are, um,

since instituting that scene, are

compliance with that, um,

increase substantially by

doing that.

Thank you, Alan. And and I think

it I mean, what you just laid out is a very good example

of that synergy where product

meets partnership meets you know your own

best practices with your staff

and how you build that full workflow starting

from the product itself.

And then you basically described that also

different modules, different different

people, different roles,

putting and consuming data through different

modules of the system from charting

pre procedure, intra procedure, human

dynamics reporting on so

on. I mean, how that all combined

together through that shared, unified

back end of that single database. Um,

and then that data gets exported,

Um, to whatever industry submission.

Like you said, you use specific vendor,

but whatever registry submission, vendor

of your choice on,

by the way, I know that's not part of this discussion.

That same work flows about how that interacts

with the m r.

Um, and the data goes over. As Cathy

said earlier to the relevant positions, um,

so everything is tied in. Plus, on top

of that, all the best practice work so that

you have and you have put in place with your staff

Um,

um and and that, and enabling

you to achieve that end go off

having um, the most minimal

overhead for for this sometimes

tedious task of, you know, getting all the

registry or reimbursement relevant

data that properly document

and properly signed. So really

making that is just part of the on the flow

part of the day to day work that each

each person does their job does their own

role. And then all that data

just gets gathered along the way very

efficiently. And that just means

you're in better compliance. And, uh

um, um, and a better alignment

also for, ah, reimbursement.

And then Allen moving over to this, um,

next section.

When I looked at this, I thought a very good example

of how you know critical just have all

the proper elements and product that supports

the work flows. Um, in place.

Can you go over this? This example

just is another way to look at what we

just discussed.

Sure. Um,

so what we would do is if

you know, to make those changes to the gooey,

we would open a ticket. Um,

with change. Healthcare, too,

You know,

at our proposed changes

and turnaround time on, that was

usually

around two days. Um,

So

what we really like about last

year? In 2019, we instituted

the peripheral vascular package.

Um, which is on a different

type of platform. Where I is an administrator

can make those changes without

opening a ticket.

Um,

which really cuts down the

time that it takes.

I can make that change,

if that's if it's ah, you know, when

we speak to our physicians. And that's definitely

an approved change that we definitely need to make.

I could make that change

the same day. Um,

within the peripheral vascular package.

Um,

and

we can start documenting. That assumes

that changes made.

Um,

so I'm really looking forward Thio from,

um we're going to 14

3 at the end of this month.

The echo package, um,

is set up on that same platform. I'm

looking forward to that change because there

seems to be a lot of, you know, there's

changes coming with that as well.

Asi faras registries and

documentation needs.

Um,

so I'm looking forward to that, Especially

the calf when that happens in in a

future version, we're definitely interested

in Thanks,

Alan. And I think this I mean

I mean, this last two slides described very

well how you know the report. Flexibility

the customization. Plus they know the supporting

layer, uh, from the from

the vendor insurance eventually

that that you get what you need for compliance and efficient

data flow.

Um, and

and and specifically what? What Alan was

just, um, talking about now

just to get some context for our listeners,

Um is really about, you know, this this report

editor that empowers, you know, Alan,

Alan, in this case, for maximum flexibility

to adjust reports per the staff

needs, Um and that that that

the use case that Allen described of

a stenographer physician

asking tiu move a field

or add or remove a

field,

Um, place it somewhere

else. Um, and the capability

to basically do that in a matter of Amanda minutes

immediately. Apply that,

um, that really is taking that, you know, product

fit to solve the problem to the next

level, ensuring,

um, there's always an immediate update.

Work flows for the reimbursement purposes

for the compliance purposes and

also for a clinical use.

Um, and basically,

as as Alan, what was also alluding

to keep yourself very happy with

this super quick turnaround

time,

Um, on on any of these requests

and to summarize the section,

um, we talked about,

um again

driving in another layer of how the

actual flexibility of customization

within that

single cardiovascular. Um

um Um um, database

I'm derived work flows.

How That helps.

Um,

um in Washington health meet those

challenges, um, offered

hearing to the different in many, many.

And all of you are aware of this many different

compliance and reimbursements

documentation requirements.

Um, so it's really a combination

of the product of the best practices

employed at the facility.

Um, and of course, of the overall supporting

layer from the vendor to make sure that

there's proactive support that,

um, you requirements are met in advance

on de any assistance of consultants

is needed. And there is a very quick turnaround

time on that as well.

Right here

and now work going over to

the last section before we

turn over. Uh, q

and A.

Yeah. So I wanted to discuss,

uh, you know, what are the challenges to

really unlock the value of of

data and translate that to meaningful,

actionable insights

where you can get objective, meaningful

visualization of where you can improve

and also monitor where you're doing well

to make sure that it stays that way.

Um, and of course I'm talking about

um um, analytics,

um, one of the most important areas

within cardiovascular solutions

in terms of the value potential

that could be derived

if the product fits. And if you

have both, internally in both with your vendor,

you have the expertise into how

to use this to its maximum potential.

Um, because there many challenges in this

area,

for example, of how do you consolidate

across different systems? How

do you meet and track your

goals? How do you identify improvement areas

and act upon them?

And when we were

just going to go over to some very cool

examples of how this works,

But when we look to approach these challenges,

it brings us back where we started from,

Um, those superb workflow

driven by a broad solution on a single

database

because you can have the best analytics, you know,

visualization platform in the world

was beautiful graphs and dashboards

and capabilities. But if you do not have quality

data that is consistently consistently

being inputted into that system,

then those nice dashboards will just

be empty. Of course.

So you need first of all to get the

data answer so you have what to analyze

and you need to promote

at the entry of structure data,

you need to have the product works off in place that

the drives act,

um, starting from the actual usability

of each one of your modules across your

cardiovascular work flows

and also how those modules interact

with each other, enabling things

like what I talked about before. A single point

of data entry.

And you need that to be, um,

um the easier route for your staff.

The one they want to take.

So they want to put the data in.

They're just doing their job.

And in the backhand. We're collecting all

of that, um, into that single,

um um, data lake

or that single, um, a databases

database in this case,

Um,

and once you have that, once you have

that that's one single database across

all work within domains and facilities.

Then that's where the data flows

to, um and that's data

that you are now going to use to drive your

operational efficiency than many other

things. Which, which Allen is going

thio to provide some. Like I said, very

cool examples.

Um, so, Alan, um,

can you go ahead and

describe some of the ways that you know Washington

health is using, You know, everything We just discussed

that flexibility those works, those all those

small adjust working seamlessly together

and having all that very high quality

data in your in your single

database.

Um um, how are

you utilizing that to really, um,

in a different area? Thio Dr.

Actual insights and really be a data

driven organization.

Yes. So I used the

product is called It's called Cognitive. The Analytic

product. Um

and I mean Cognos pretty much every

day. Um,

I use it to if a physician

needs to be re credential, administration

will contact me about which positions need

are up for re credentialing. And they will

want,

um,

how many procedures that patient

or that physician has done

s O. I have a report

built that all I have to do is change

the time frame. And it

will tell me how Maney casts they did. If

they do pacemakers. How maney pacemakers

they did. How many new Met exams?

Um, they that they

that they read echoes.

Um, so I use it for credentialing.

Um,

I do it. I dio monthly statistics

for administration.

Um,

both monthly and bi

weekly.

The bi weekly. Um,

they look at that,

um, assed faras staffing.

Um,

and they're evaluating our staffing based

on the numbers that I'm saying that

I'm sending them through.

Um,

I also run reports.

Um, I probably have a couple 100

reports that that I have that are

on that I have quick access to,

um,

back in 2019,

we started a valid clinic.

Um,

and so we added, Ah,

field on are eco reports

for, um

and the patient had valvular disease.

Are they a valve clinic candidate

And which valve?

Um, so

I run a report that runs every

day automatically. It's pre

scheduled That looks at,

uh, that information and

it sends that report. Um,

Thio are Val clinic nurses.

So that,

um, we don't have patients that fall

through the cracks so that they know which patients

that they need. Thio.

They need to follow through the office to

make sure that they get into the valve clinic.

Um,

another

example is, as we had a physician that

started

I wanted to do same day, discharged

for our PC I patients. So,

um, they came up with

kind of a rule of thumb that the

PC I The procedure would need

to be completed by noon

for that patient to qualify.

So the first report that Iran was

how maney PC ice did we have

that were completely They were completed by new

to find out if there was an actual

volume. You know, if there was enough volume

Thio to pursue this,

um

And then once we found that we did have that,

um,

and we implemented that process,

I have a daily reports that

runs.

Um,

that same report runs daily to tell

us which patients were completed

by noon,

and then we double check that list to see

Okay, Were they discharged the same

day? And if they weren't,

then we investigate on

what factors contributed to them not

being,

um,

not being discharged by, you know, on

the same day, Discharged.

Um,

so those were two,

two examples. Um,

the big reports that

I used,

um, I also can run those

analytic reports on that second

facility.

Um, I can, you know,

drill it down by by

facility code. So I

count numbers

both bi weekly and monthly for that

facility as well, so I can tell

um,

how many EKGs were done? How

many echoes were done? How maney stress tests

were done.

Um, and that is using,

uh, the biweekly numbers. Air used

thio determine staffing. They're

a swell,

Um, another example for

staffing that we, uh, developed

waas, um,

our build a report

that ran to tell toe

See how many outpatient EKGs

were done.

Um, after 3. 30 after

our staff are cardiology staff

left, uh, that second

facility left for the day and

rest. The story would have thio.

You know, once our cardiology staff

leaves, respiratory does are,

um are EKGs

after what we call after hours.

And so

we looked at that to see if we needed

to change our cardiology.

Um,

hours of operations is we make need

to make our hours longer,

you know, Could we make them shorter, so forth?

And so on?

Eso those. That's three basic

examples that I've

reports that I felt, um,

and you can drill it down. You could make it a

Z complicated as a report

that you need thio auras. Simple as a report

that you needed tohave.

Um,

it's all you know, it's

it's all in what you need toe

on what you need to get out of it. And but,

of course, it's what you put in. The data

you put in is the data that you get out.

Thank you. Thank you, Alan, for

that detailed overview

just summarize section,

Um I mean, I

think you mean and you said there that I could

never say it, but But just just those

those examples of, you know, different domains,

different work flows and all the different

types of incident. And as you said, you

can have hundreds of reports you don't need to manage

them. A lot of them are out of the box,

but you have the ability to adjust them, and there

could be automatically sent

on. But it's really about getting,

um um getting it down

and refining it. Thio that really

insightful piece of data that you need

to affect your your resource is in

your patterns and your operations.

Um, and it just becomes much more

easier where there when that

data is consolidated, where it just flows

them from all the different different

roles and different users and different

modules.

Um, and you can have, you know, benchmarks

and cross sections and really derives. I'm

true insights that you can. Then

you know, once you implement your action items,

you can then go back and see over time

how that is trending and monitor and see.

Does that really have the effect with if we

wanted Thio? Or maybe we need to do something

else to improve this part

and meet our objective,

Um,

so

quickly before we turn over

Um Q and a,

um

just to summarize three sections we talked

about today and I'll try to do it

quickly. So we have some time for Q and A

starting with that, you know, single database

architectural. We talked about about how

having a broad solution on a single

unified architecture, er,

and that the modular flexibility with

the different, um modules

in some modules enables

the most optimal fit. Um

um of a cardiovascular system into

an ecosystem. Um,

maximizing the investment your

your EMR hr investment

enhancing. Clinical work flows, reducing

I t overhead.

Um, and really driving enhanced efficiency,

reduction of TCO

and just better experience

for your staff in and and and

for the patients.

We also talked about how the proper

product fit combined with

best practices combined

with with a good, um, supporting

consulting layer from the vendor.

All of that together, um,

can can perfect your

documentation, make sure all the data

is there is a line and and then

promote

better compliance, be

it registry or reimbursement.

And finally, we talked about the importance of

being, ah, data driven organization

about that so

much value that's in

there when you have those work clothes, when you have

that data, um um,

flow into that single

single place

on bits quality of data that you

can really, um,

run those analytics on,

um

And And you have also, of

course, a consulting you need from your vendor

to make sure you really focus and and and

10 points exact bottlenecks.

Exact areas where you can

either confirm your workflow

is is running well, and you can monitor

that or find areas where you see

areas where you can improve and then have

the tools to monitor that later to

see that you were effective

in your changes.

So that's, um,

um, the summary of what we discussed

so far. Um

and I think well, now we all have

some time for Q and a So, Dave, I think

I'll pass this on

back to you.

Right. Well, thank you very much for the presentation

before we start questions. I just wanted

to remind everybody, uh, that you

can't ask questions using your viewing council.

We've got a few in any questions that we

don't get in the top of the

hour. We will answer offline. So

feel free to ask any questions that you might

have. Um, the first

question that came in and Oriel

let you figure out who is probably best

to answer this, uh, the lack of interoperability

between cardiology imaging systems and see

tax. A swell is the lack of standardization,

such as cardiogram fee stream measurements

within the industry. You have long been cited

a tech analogy. Problems for cardiology imaging

systems. How is the vendor community

addressing these thes issues?

Yeah, I think they I think I'll take that

one. And and I assume that the meeting was

cardiology system and tax.

The radiology packs is part of the broader enterprising.

Uh uh,

Yeah, it's part of the broader enterprise

imaging. Um um,

overview. Um,

so I think I mean, I think that the main

Koreans or of course. And what should be expected

and what we talk about? The vendor community, um,

is really, um and, you know, over

the years, and I completely agree it has been

a knish. You, um, in the past,

but as, um, interoperability

has become more standardized.

Um, then I think it

zits now

more of of, of also a standard

for the vendor community to to to

support and promote standard interrupt our

ability

with options like, you know, a p

I s and inbound outbound communication

based on standard based protocols.

Um, and this

today, it's really, um

um, um should

be able to say a no brainer because it's still

sometimes connecting different systems.

Um is a challenge, but I think

most vendors in the vendors community they know

how to speak the same language I know

for for us as an example,

um, we have broad amount

of interoperability. I talked a lot about Mars

being that large part of the ecosystem,

but also with others third parties in the ecosystem.

Whether it's contextual launches,

um, accessing view, accessing images,

sending data, receiving data. Um,

and obviously we have a lot of that experience,

so it's very easy to plug and play, and we've probably

done everything,

but but you can never really do everything.

So so there is a place for sometimes

you. You come to a customer

and there is a you know, a desire for a new type

of interoperability, but it's usually

when you, when you dig in it usually does flow

back to that same standardize

interoperability. So it's much easier

to address that.

Another question that came in eyes for

Washington hospital. Uh,

for Washington Hospital. Ease of dead entry is

a key benefit. Cardiologists want

further imaging systems. How is your

technology doing in terms of meeting that

expectation?

Hi, Cathy,

I think, as the physician's request

things, whether it's mandatory things

from the governing bodies or if

it's things that they want to get out

of the system. The system is

very flexible,

and we can build things

and make them mandatory from

our staff point of view. So they have to put

the data in at the end of the case,

so the physician and

Alan could build a report to get

the data back out.

Is

that's sufficient?

Aylan. Did you have anything to add to that

how how your technology is doing in terms

of meeting the expectations.

I think that, um

I think that they are because there's new things come

up on the physicians come

to us.

Um, we can add

change.

Um,

by simply, um,

by simply opening a ticket. Um,

example. That is,

um, within our,

um, echoed reporting system. We

have a physician,

um,

that wanted to address,

uh, systolic dysfunction.

And they were having

is a group that they were,

um, the concern waas they were

using. It wasn't very clear on

criteria assed faras,

different levels of systolic dysfunction.

So

we developed the page in our eco

report specifically for that.

And on those

on that page, it was a

clear cut,

almost like a pathway. You know,

if this value is this, you

perceive the

thio, the next level,

and as you went to work your way through

it, it helped. It made it very

clear to the position on which,

um,

which type of systolic dysfunction

they had. So that was

that was one instance where we were able Thio

meet the group's needs

as faras um,

a change that they wanted

Another question here. Cummings What do capabilities

should the market expect in

new cardia Cardiology imaging

technology to further improve clinical

outcomes?

Yeah, I think I mean, I'll take

that, um,

so I think, um I mean, the things

you know we're looking at now and then we're seeing,

you know, also also in the market right now is

really that strong focus and and then those.

It's the word. I use the lock here about

interoperability. Um,

while it is becoming standard,

um, it's never ending road, never

ending journey. And there

will always be right more than one system

in that ecosystem

and the ability to make it, you know,

thinking about that end user about the

pornographer or the physician

that needs to consume the data, needs to

do their work and take care of the patients.

The more work the industry could do to

make it to make those transitions between

between the Amarna cardio cardiology

system as seamless as possible.

I mean, almost to the verge of it, feeling

like one system. If that is possible,

I think that's a very strong focus area,

so that will continue to involved with better

standards, better communication between the vendors

on on the product level. The new

platforms new concept for

for, uh, data flow for reporting.

We talked about empowering users or

end users to quickly customize what

Allen also was just talking

about with some of

of off for change

healthcare. Example. Some of of this, this

new report editor piece that

really allows a fast reaction.

Andi, Fast turnaround time

on physician request

on being able to get those the documentation

just perfect to promote compliance,

to promote

reimbursement. High reimbursement.

Um, and finally,

everything having to do with remote work flows,

obviously becoming much more.

Um um

um focused Now, um,

um, in light of of Covic. But but also

before the ability, especially

for the non invasive works with and cardiology

to really provide full anytime,

anywhere diagnostic works well,

access.

Um, from everywhere I mean that that's

something that you know, for change health, for example.

I mean, we provide today, but it's something

that's always evolving.

Um, as more tools are added

to those remote capabilities than being

able to address in these of the future.

Um, so really making sure

that we keep providing that you know, the

community keeps providing that access

um, Thio Thio physicians

to do their work remotely. When you

modules are developed, when anything new comes

in to make sure it fits there,

we're at the top of the hour. I got one last

question I'm gonna ask, and then we're going

to wrap things up. There are a bunch of questions we haven't got to,

but they will be answered offline to those who have asked

the wealth question. Hopefully,

we'll keep it brief. Is do you use structured

reporting other than echo such as the cath

lab? Um,

I can take that. Yes, we do use, um,

structured reporting. Um, in

the cath lab,

um, as well as, um,

for a pia's. Well,

great. Thank you. You know,

that's you know, and then if there's a change

that needs to be made, we can

you know, we opened a ticket and make that change

If we need thio.

Well, that's all the time that we have to question

today again. Thank you for everybody

who attended and any questions that we did

not answer. We will answer offline

on behalf of D SC magazine and our sponsor

change Healthcare. We'd like to thank everybody for their

participation thing. So long, everybody