The CFA Perspective

Cardiovascular Information System (CVIS) Optimization and Effective Structured Reporting

Posted by Patricia Tyler, RN

6/26/16 8:21 AM

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Are your cardiologists reluctant to give up old fashioned dictation and transcription for cardiac catheterization (cath) lab structured reporting?  Hospitals throughout the country are mandated to have all patient documentation entered into an electronic medical record by the year 2018. Cardiology professional organizations have collaborated and developed a health policy statement which includes a list of reasons encouraging physicians to use structured reporting for cardiac cath lab procedures. 

“It provides a concise and efficient way to package critical information, not the least of which is serving as the legal medical record.”[1]

Even with government mandates and professional organizations encouraging structured reporting through healthcare policy writing, many hospitals still struggle to find an effective way to encourage and motivate their cardiologists to complete procedural reports electronically through structured reporting.

Most hospitals have selected and invested in state of the art data collection and reporting systems for their cath lab which offer structured reporting either with or without PACS archival.  However, if the technology is not optimized and interfaced correctly with the hospital health information system (HIS), or structured reporting templates are not designed and customized to the physicians’ liking, or the technology is not set up correctly to support the clinical workflow of the department, it will not be utilized by the physicians at all or in an ineffective fashion.  This creates additional work for the staff as they must develop time consuming workarounds in order to get data into the hospital’s HIS.

Some of the chief complaints from the physicians are that structured reporting is labor intensive, and it does not produce quality comprehensive reports that they are willing to sign.  This problem applies to all vendor products and does not single out any one software product.  There are a multitude of reasons structured reporting fails in the cath lab environment and the reasons are different for each hospital.  The key take-away focuses in on “customization.”  No off-the-shelf product can provide an optimal solution for every hospital under all circumstances without some degree of customization.

The good news is that an increasing number of hospitals have 100% of their cardiologists doing structured reporting efficiently and effectively.  Consequently, these same hospitals have been able to:

  • streamline their documentation workflow processes
  • improve operational efficiency, quality patient care, and staff/physician satisfaction
  • improved productivity and throughput resulting in an increase in the number of procedures able to be performed in the cath lab

These improvements and efficiencies have resulted in increasing the revenue stream and achieving demonstrated cost reductions with the proper implementation of a customized CVIS solution.

A key to success for these hospitals is having an experienced Cardiovascular Information System and CPACS administrator with the right technical and clinical expertise.  This level of experience and knowledge is critical to successfully managing CVIS implementation projects and to providing the support for the optimization of technology, physician and staff education, template modification and build, and to develop and implement a future state CVIS solution that will meet the specific needs of the cath lab department, hospital and its cardiovascular physicians.

When a hospital does not have such a capable and knowledgeable CVIS staff member on its cath lab team, the interim solution to achieving effective structural reporting and measurable staff efficiencies in the near term may be achieved through accessing CVIS consulting expertise.  Working with a team of CVIS integration specialists that help your department and cardiology medical staff achieve effective structured reporting processes, capture clinical and procedural documentation accurately and efficiently and help to improve the accuracy and timeliness of charging and procedural reporting will help benefit your department’s overall performance in many ways.

Should your department be in this situation, there is that light at the end of the tunnel and it’s the brighter future of effective structured reporting and improved efficiency…and not just the train heading in your direction!

If you are interested in learning more about CFA’s CVIS consulting services, please contact us at (949) 443-4005 or by email at CFA@CharlesFrancAssociates.com.

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[1] Circulation 2014;129:2578-2609; http://circ.ahajournals.org/content/129/24/2578.full.pdf