SAN DIEGO - A cardiology image and information management system (CIIMS), a combination of a cardiology information system and cardiology PACS, has data objects and processes that are unique to the specialty. As such, although many of the precepts gleaned from radiology RIS/PACS integrations and installations are valuable for facilities implementing CIIMS, there are modality elements and data types that make these systems unique.
"Unlike a radiology PACS, where the majority of the images are static, a high proportion of dynamic images are necessary for cardiology," said Nathan Pinkney.
Pinkney, senior project engineer with health services research agency ECRI of Plymouth Meeting, PA, delivered his thoughts on cardiology PACS and information systems in an e-session presentation at the Healthcare Information and Management Systems Society (HIMSS) conference.
According to Pinkney, the multimodality makeup of cardiology requires synchronizing information from a variety of different sources. A CIIMS may be necessary for groups that wish to interface with nonimaging cardiac modalities such as ECG devices, hemodynamic monitors, and documentation systems.
Traditionally, CIIMS have been used to manage cardiac catheterization laboratories and echocardiography images. The expansion of cardiac diagnostic imaging has necessitated the inclusion of diagnostic presentation tools for nuclear cardiology, CT, MR, PET, vascular sonography, and intravascular ultrasound within a CIIMS, Pinkney said.
No matter whether a CIIMS configuration is to be a standalone department-only project or a universal system component as part of an enterprise-wide electronic health record (EHR), Pinkney holds that a seamless flow of images and information to clinicians should be readily available. From a practical standpoint, he believes that the capability for integration with other healthcare systems should be part of a CIIMS from its first implementation.
"Integration with imaging modalities and information systems is essential to a successful CIIMS," he said.
To ensure compatibility with other image and information systems within the healthcare enterprise, Pinkney advocates that a CIIMS, like a radiology RIS/PACS, be DICOM, HL7, and Integrating the Healthcare Enterprise (IHE) compliant. In addition, he suggests that cardiology departments look for digital dictation, speech recognition, and structured reporting capabilities in a CIIMS, as this allows for quicker generation of reports and increased throughput for a busy facility.
Because of the dynamic nature of much of cardiology imaging, a storage strategy and capabilities will need to be mapped out prior to a CIIMS implementation, Pinkney said. A busy facility that generates multiple gigabytes of data on a daily basis may want to consider an online, near-term, and long-term architecture to address its storage needs and meet legislative requirements for redundancy.
Similar to radiology, CIIMS workstation configurations will be different for the diagnostic clinician, who will generally need a higher-resolution display, more robust presentation software, and more powerful workstation, than for the referring physician or other hospital locations, according to Pinkney. Also analogous with radiology are issues of security, HIPAA compliance, and remote access, he said.
Lastly, as in radiology IT purchases, Pinkney noted that a major factor in the purchase of a CIIMS is the service level provided by a vendor. As such, a facility needs to ensure its comfort level with developer-provided services including planning, integration, installation, user training, upgrading, and continued CIIMS operation.
"The relationship between a hospital and a CIIMS supplier lasts for the life of the system," he said.
By Jonathan
S. Batchelor
AuntMinnie.com staff writer
February 13, 2006
Related Reading
Cardiac PACS pace quickens, September 22, 2005
Flexibility crucial for bringing PACS to the ED, OR, and ICU, June 7, 2005
Many skills needed for cardiology PACS administrator role, April 25, 2005
Diagnostic imaging and clinical information systems: An integration primer, April 14, 2005
Cardiology PACS has its own unique needs, June 11, 2003
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