Feature article

Why Structured Reporting in Cardiology Means Better Teamwork, Efficiency, and Outcomes

Streamlined Data Entry Negates the Start-from-Scratch Models of Yesteryear

The sheer amount of data involved in cardiology can boggle the mind. From intakes to images — and procedures to discharge logs — a patient chart fills up fast. Keeping track of all that data in a way that makes it easily recorded and retrievable creates a challenge indeed, but one that structured reporting can solve. And in many centers, already has.

But what exactly is structured reporting? Dr. James Tcheng, an interventional cardiologist who teaches the topic to Duke University medical students, sums it up best:

“It’s a team-based capture of information that’s integrated cleanly and effectively into clinical workflows — distributing responsibilities for data management across all members of the healthcare team,” he said. “So if you’re caring for a patient and you happen to be the closest individual to a piece of data about that patient, it’s your responsibility to capture and manage that piece of data at that point in time.”1

Faster Documentation, Faster Billing

That kind of a multi-source inputting system saves time and resources, thanks to a more efficient workflow that negates the start-from-scratch data entry model of old. Physicians, nurses, technicians, and other staff can simply pick up where the previous one left off, adding more color to the grand tapestry of every patient’s medical record.

“When all members of the team are doing components of the documentation, you can cut the amount of time to document a procedure by more than 50 percent, and you can make the final reports available almost immediately,” Dr. Tcheng said. “The mantra is capture once, use it many times.”

This extemporaneous way of adding data bit-by-bit during a patient’s treatment journey accelerates the reporting flow across-the-board — which means quicker information transfer on the backend with faster billing, too.

At Duke, for example, Dr. Tcheng’s team completes a patient’s final procedure notes before that patient even leaves that environment.

“You can then communicate to the next provider who opens up that document,” he said. “You can also bill a lot faster, so it actually saves time and money, improves the data accuracy, and increases the responsibilities of all team members.”

Better Teamwork, for One and All

In those environments, structured reporting gives everyone a job to do in the realm of data collection and input — which, as Dr. Tcheng notes, builds not only teamwork but also confidence in individual contributions for the greater good.

“When different individuals are responsible for different areas of documentation, they know they become responsible for that piece of data — and that set of information is going to be used by others,” he said. “These dependencies are then self-reinforcing so that everybody feels better about their contributions to the processes of care. It’s actually a job satisfier.”

Structured reporting touches many team-based clinical environments, but one of the settings most conducive to data standardization is the cath lab. The American College of Cardiology encourages structured reporting in that scenario, providing a sample data input flow from pre-procedure to procedure and analysis that assigns team members logging responsibilities at each step.2

Cardiology Reporting, Unified

The beauty of that process, of course, is that it consolidates the data from many specialists and departments into a unified language and format they can all collectively access — centralizing the disparate templates and redundancies often seen in non-structured systems.

That single-format approach auto-files information about the patient for the benefit of all practitioners. Consider, writes GE Healthcare’s The Pulse, the convenience of having your address, usernames, and passwords auto-populated at the dozens of websites you visit every day.3 Structured reporting provides the same time-saving value to clinicians.

Boosting Outcomes with Predictive Insights

And it doesn’t just improve efficiency or teamwork — outcomes benefit too, thanks to real-time analytics and predictive insights. Not only can you improve reactive care and decision-making through faster information flow, you can also potentially predict patterns before they turn dangerous.

“You can imagine aggregating lots of patients’ data, understanding the time course of diseases,” Dr. Tcheng said. “So let’s say you’re in the echocardiography laboratory and you’re following a cohort of patients who have some degree of aortic stenosis. The tech performs the echocardiogram, and the system could then understand what the values were from six months ago, and a year ago, and anticipate the trajectory of that particular patient’s aortic stenosis. From there, it could determine, for example, that in January 2020 you should be thinking about replacing this patient’s aortic valve, because in February 2020 he or she is going to get into trouble."

How Technology Makes It Happen

If the potential of all that data boggles the mind, the technology that makes it possible should too. Enter Centricity Cardio Workflow, a single-system structured reporting tool that helps cardiology teams log patient encounters more accurately with fewer clicks, less time, and less complexity.

Combining images, patient records, inventory, and waveforms with end-to-end customizable workflows, the platform gives remote access to data with advanced features, like auto-distributing reports to multiple destinations and inventory management.4

For systems that have adopted it, the results speak for themselves: Europe-based hospital Klinikum Nuremberg compressed the time it took to do a cath lab report from 15-20 minutes to just 5-10, with quality control compliance shooting up from 95-98 to 100 percent.

“Our cardiology department is as complex as the patient cases we manage,” said Markus Schmidt, Project Manager of IT at Klinikum Nuremberg. “GE Healthcare understands that complexity and brought a thorough and passionate approach to delivering a solution that drives clinical quality, improves operational efficiency, and ultimately helps doctors do what is most important – spend time with the patient.”5

 

References:

  1. Q&A with Dr. James Tcheng, Duke University. GE Healthcare Insights. https://insights.gehealthcare.com/qa-with-dr-james-tcheng-duke-university/. Accessed June 20, 2018.
  2. Integrating Structured Reporting in the Cath Lab. American College of Cardiology. http://www.acc.org/tools-and-practice-support/practice-solutions/health-information-technology/health-informatics/initiatives-and-solutions/integrating-structured-reporting-in-the-cath-lab. Accessed June 20, 2018.
  3. Cardiologists Will Soon Be Data Scientists, Too. GE Healthcare The Pulse. http://newsroom.gehealthcare.com/cardiologists-will-soon-be-data-scientists-too/. Accessed June 20, 2018.
  4. Centricity Cardio Enterprise. GE Healthcare. http://www3.gehealthcare.com/~/media/documents/us-global/products/healthcare%20it/brochures/centricity-cardio-enterprise/centricity-cardio-enterprise-brochure-jb44162xx.pdf. Accessed June 20, 2018.
  5. In a Heartbeat: This Tool is Cutting Down the Clicks in Cardiology Care. GE Healthcare The Pulse. http://newsroom.gehealthcare.com/in-a-heartbeat-this-tool-is-cutting-down-the-clicks-in-cardiology-care/. Accessed June 20, 2018.