The landscape of cardiovascular care is changing with a rise in complexity and volume of cases, cardiologists are faced with sifting clinical and imaging data from disparate sources, performing in high pressure environments, all while trying to provide the best patient care. In turn, Northwell Health, one of the nation’s top hospitals, took a unique approach to these challenges.
Northwell Health has a wealth and breadth of complex cardio care across three regions and about 22 healthcare facilities, including 18 functioning electrophysiology (EP) labs responsible for 11,000 cases every year. But this complexity once came at a cost.
The data flowing around the clock from everywhere clinicians performed cardiac procedures was challenging to manage across facilities. However, Northwell came to recognize an opportunity to deconstruct its sheer size and volume of cases and use this complexity to its advantage.
At a recent Cardiology Coffee Break, we spoke to Dr. Nicholas T. Skipitaris, Western Regional Director, Cardiac Electrophysiology at Northwell Health, about how this led to saving time and increasing value in their reporting.
The Challenge
Adopting new reporting processes can put pressure on cardiology departments for a variety of reasons, many of them around resistance to change. Each physician has their own needs in terms of what reports should look like, what data to gather, and how.
This was especially challenging for Northwell, which over the years has acquired many different hospitals, each with its own homegrown or legacy-type solution for cardiac EP reporting, billing, inventory management, and more. These solutions would run the gamut from dedicated cardiology software, such as GE Healthcare's Centricity Data Management System (DMS), a prior generation of Centricity Cardio Enterprise1, to scattered Word documents. Another challenge unique to Northwell was integrating GE's systems with its electronic medical records (EMR).
"I know it's possible to do a more bulletproof integration between the two systems, but it turns out that the source of truth for patient data and clinical information in our system has to live on the EMR," Dr. Skipitaris explained. That was a problem, he said, because "we were initially doubling up where we entered data—both in the EMR and into Centricity Cardio Enterprise."
Generating a history and physical, for instance, became too cumbersome to do in two places. "Because of the limitations of our EMR system, we were unable to put data in a single place and have it go everywhere," Dr. Skipitaris added.
It was important to Northwell not only to support the individual needs of its physicians but also to create a system that could be accessed and utilized for larger purposes: strategic data gathering and maximizing departmental efficiencies.
The Solution
For Northwell, the solution came two years ago with the launch of the new iteration of Centricity Cardio Enterprise at Northwell's flagship hospital, Lenox Hill in Manhattan, New York. CCE was the natural choice for this team, who were already familiar with DMS and drawn to the customizability and centralized nature of the system.
"Electrophysiology is a complex specialty—it's very diverse in terms of the types of procedures we do, but at the end of the day there's a finite number of procedures that we do. So what we were trying to create was one platform where all electrophysiology could be accounted for," Dr. Skipitaris said.
"With the number of procedures we do, we wanted to standardize how that was reported out, have that mesh with the financial piece of working in a healthcare setting, and make sure there was a single place where inventory would be tracked and our research needs could be satisfied when it came to cataloging the types of procedures we're doing."
Thus began the process of exploring how to make CCE work smarter for Lenox Hill. The team found that by deciding what to incorporate into their workflow from the beginning, they were setting themselves up to successfully meet all the needs they had identified. This careful exploration even opened up avenues they hadn't expected, such as the capability to assess their lab efficiencies and use of space and human resources.
However, getting CCE to work for one hospital was only the first step. For the system to have the most impact, Dr. Skipitaris noted, it needed to be easily introduced to other hospitals. "We needed to set it up in a way that could be scaled."
The Journey Continues
The launch was complex in terms of system integration, and Northwell had further challenges to navigate from an IT perspective. Dr. Skipitaris went on to share what he might have done differently at the start, but how the benefits of Northwell's new standardized platform are still being realized all these months later.
"Since we rolled out a couple of years ago, we have hospitals that have subsequently started using Centricity Cardio Enterprise … the stuff we worked on a number of years ago continues to evolve but continues to be introduced to new places."
You can watch our conversation to dive deeper into the steps Dr. Skipitaris' team took to streamline reporting and the many ways their solution is evolving and improving their operational efficiency today.
1 Centricity Cardio Enterprise is a solution comprised of Centricity Universal Viewer and Centricity Cardio Workflow.
