Face to Face: Trends in Cardiology

Cardiology is a growing, rapidly evolving segment in the healthcare arena. The last several years have seen tremendous advances in cardiac imaging and information technologies, such as the introductions of the first magnetic catheter navigation system, 16-slice computed tomography (CT) systems that can detect soft coronary plaque, and new self-gating magnetic resonance (MR) software that eliminates the need to obtain an electrocardiogram (ECG) signal. At the same time, the number of cardiac patients is rising. According to the World Health Organization (WHO), in 1999 there were 7.1 million deaths from coronary heart disease globally. The WHO predicts that by 2020, this figure will rise to 11.1 million. Robert Dewey, director of Siemens Medical Solutions Cardiology Program, provides some insight into how cardiac care is changing for the better.

Q: How is imaging technology changing the face of cardiology?

A: In today's world of healthcare, there is the need for speed, accuracy and safety.  High-speed multi-slice CT scanners and MR systems are really stepping up to the plate as effective, less invasive imaging techniques for diagnosis and treatment planning. These modalities play complimentary roles with MR having its primary strength in functional imaging, while CT focuses on visualization of the coronary arteries. In echocardiography, new products offer the highest image quality available, from high-end systems to powerful, yet portable and lightweight systems.

Q: What role does technology play in detecting cardiac disease early?

A: The use of CT and MR technologies for non-invasive angiography applications is particularly notable in improving earlier detection of cardiac disease. For the first time, doctors can obtain hard evidence of heart disease without surgery. As they now have the tools to visualize soft plaque, long known by researchers to be the cause of heart attacks, they can catch signs earlier. Exams take less time, and immediate access to images allows for faster diagnosis and faster treatment. With its ability in stress echo testing and the increased sensitivity for the visualization of coronary arteries, echocardiography is also making a strong contribution in early detection.

Q: What affect does it have on the ever-growing statistics of heart disease?

A: For many patients with heart disease, the first real symptom is heart attack and occasionally death. But with these new tools for diagnosing disease in its earliest stages, technology is improving the chances of detecting and treating patients before that heart attack occurs. In all cases, time is critical for cardiac patients, and that is why information technologies are so important. When you can give clinicians the tools they need to more rapidly and accurately move from diagnosis to treatment, you enhance the patient's chances for recovery. All of these advances will ultimately have a positive affect, and help clinicians make inroads toward lowering the statistics of heart disease incidence.

Q: How important is integrating cardiology information with data throughout the hospital?

A: Delivering clinicians with all of the clinical data for a patient at the point of care is increasingly critical for best-in-class cardiology. Whether it's in a patient's hospital room, within the hospital, in a physician's office or home, or even on the go via a PDA, new solutions must present patient results and images with speed, superior image quality and in a standardized format. Systems like Siemens Soarian give access anytime, anywhere to a full electronic patient record (EPR), arming doctors with the information they need to make the best possible clinical decisions. This means avoiding errors and saving lives.

Q: How do filmless imaging and paperless files fit into this movement?

A: Filmless imaging is an important factor for improving workflow and patient care. A unique approach adopted in the development of all Siemens imaging systems has all modalities adopting a common platform known as syngo. This acts as the highway for seamless image exchange across modalities - allowing a cardiologist standing in the cath lab to query and display images for the patient that reside on the other image acquisition systems, such as nuclear medicine, MR or CT, without leaving his or her side. PACS provide accessibility to digital cardiology images and allow them to be viewed simultaneously in the cardiology department, the operating room and the physician's office. Digital images also mean elimination of films, minimized storage requirements and dramatically reduced retrieval time for old images.

Q: How does an all-digital environment enhance workflow and improve outcomes?

A: The digital aspects of healthcare allow doctors and nurses to spend time more efficiently - with more time caring for patients and less on paperwork. South Carolina Heart Center (SCHC) is an excellent example of how digital solutions can improve workflow and reduce costs within the facility. Siemens Soarian Cardiology provides SCHC with the ability to integrate complex patient information across multiple clinical and business processes. In fact, SCHC's cardiac catheterization lab has reduced report turnaround time from days to minutes, and because Soarian has eliminated the need for dictation in the cath lab, it is saving SCHC an estimated $720,000 a year.

Q: How does an all-digital environment impact patient care?

A: Besides having more time to spend with patients, an all-digital environment ensures that clinicians have anytime, anywhere access to the information they need for timely clinical decision-making. IT solutions that enable a comprehensive EPR have built-in, knowledge-based elements that help minimize the risk of errors. Clinical results, image information, electrocardiography and waveform data are all presented at a single point of access allowing for faster diagnosis, more informed decisions and simply, better quality care. This also makes it easy for cardiologists to consult with patients and share information both inside and outside of the cardiology department sooner.

Q: How strong is the demand for integrated solutions today?

A: National issues, such as rising malpractice insurance, rising healthcare costs and the move toward evidence-based medicine have made it necessary for healthcare providers to seek an electronic solution for improved patient care, efficiency and workflow. Only an integrated, comprehensive approach to healthcare delivery will help the industry address these issues and achieve better outcomes. Such a solution should include the most advanced imaging systems for faster, more accurate diagnosis; strategic consulting to ensure process optimization and control costs; as well as the information technology component that brings all patient data together and allows access to information anytime, anywhere. This means more than simply linking up individual departments, but it means linking information from the entire hospital and beyond:  from lab results to pharmaceutical data to insurance facts to electrophysiological information and more.

Nowhere is this level of efficiency and quality of patient care more important than in the cardiac setting, where seconds count in patient health and survival. A good example of the success of an integrated solution is The Heart Center of Indiana (THCI), which opened its doors in December 2002. THCI was the first all-digital free-standing cardiac facility, built from the ground up with Siemens medical technologies.

Q: Why are we seeing an increase in dedicated, specialty heart hospitals?

A: With more than 12 million Americans having a history of heart disease, coupled with diminishing reimbursements, there is a clear need here for reliable and economical tools to diagnose and treat cardiac ailments at an early stage, and to track progression of disease in order to allow for successful medical care. The unique and specialized environment necessary for quality cardiovascular care has prompted a trend of creating specialized heart hospitals. "Big picture" solutions are needed that blend imaging and IT to give cardiologists a unique, customized solution that enhances workflow, saves time and enables proven outcomes.

THE FACTS

• According to World Health Organization (WHO) estimates, 16.6 million people around the globe die of cardiovascular disease each year.
• In 1999, there were 7.1 million deaths from coronary heart disease globally. The WHO predicts that in 2020 this figure will have risen to 11.1 million.

Robert Dewey is Director, Cardiology Program, at Siemens Medical Solutions.