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Enterprise Medical Imaging

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Royal Berkshire NHS Foundation Trust Drives up Standards with McKesson Cardiology

– McKesson Cardiology has helped to improve patient procedure reporting, support BSE accreditation and facilitate the introduction of new services including a Physiologist-led Valve Clinic

As the best-performing Heart Attack Centre in the UK, Royal Berkshire NHS Foundation Trust continuously strives to improve performance. In July 2014, the Trust implemented McKesson Cardiology™ to streamline diagnostic and clinical communications across its busy Cardiology department where nearly 2,500 cath procedures and more than 10,000 echocardiograms are performed each year.

The primary objective of the implementation was to overcome duplication created by using multiple systems that were not interoperable with each other, or the Patient Administration System (PAS). The Trust realised that in order to provide the entire care team with timely access to all the relevant information, and thus expedite patient care, coordinated, centralised records were needed.

McKesson Cardiovascular Information System (CVIS) provides the entire care team with access to the complete cardiovascular record whenever and wherever it is needed. Features include a single database to support cardiac and peripheral catheterisation workflows; EP and device management; haemodynamic monitoring; echocardiography, vascular ultrasound, nuclear cardiology, ECG management; and stress, holter and ambulatory ECG management. Additionally, the expansion of the Trust’s electronic patient records (EPR), via the McKesson system helps to ensure information is secure and accessible across the whole hospital.

With this single source of information, including patient correspondence, the multidisciplinary cardiology team, which includes ten consultants, three registrars and a number of cath lab nurses, physiologists and radiographers, has gained significant efficiencies to help accelerate patient pathways within the cardiology service. “Immediate access to all patient information in one place is a huge benefit to the clinician; and hence also to the patient,” confirms Dr. Andrew Elkington, Consultant Cardiologist, Royal Berkshire NHS Foundation Trust.

The system is also integrated with the EPR, which enables the cardiology team to pull patient names directly from the worklist into McKesson Cardiology. The integration has significantly improved timeliness when initiating new patient studies, according to Sandra Wheeler, Deputy Principal Cardiac Physiologist, and ensures the entire referrals process is both streamlined and accurate. “When a consultant refers a patient for an echo via the EPR, the McKesson worklist is automatically populated. When the echo procedure has been completed and the report finalised, it then automatically goes back to the requesting consultant, who can click on it through the EPR to get the full report.”

BSE Accreditation

Given the huge volume of reporting associated with each cardiology patient, one of biggest productivity benefits has been the ability to extend the use of McKesson Cardiology to any Trust computer, rather than only via dedicated workstations. Whilst in the past reporting echoes was sometimes delayed by reporting queues, all clinical staff can now produce reports immediately.

“Fast, efficient reporting is clearly critical to ensure the team, and patients, are informed in a timely manner,” says Catherine Townsend, Echocardiography Lead. “Timely reporting on the same day as the echocardiogram is performed was one of the key criteria for our recent British Society of Echocardiography (BSE) accreditation. Not only can Royal Berkshire’s clinicians now produce patient reports faster but we can also very quickly check that everything has been reported within the defined timeline – that no outstanding echocardiograms have been overlooked, for example.”

In addition, McKesson CVIS has enabled the cardiology team to impose far more control when signing off on patients reports, ensuring staff in training always have reports signed off by someone more experienced. This process was important both to achieving the BSE accreditation and providing full and immediate visibility to any individual’s work within the cath lab, echocardiography or angiography. In addition, the BSE accreditation team was also impressed by the fact that echocardiograms can be seen on screen anywhere in the hospital, thus improving patient information flow.

Improving Services

Streamlined reporting processes and embedded data analytics have allowed the cardiology team to also gain invaluable insight into the unit’s performance against a number of key benchmarks. Catherine Townsend confirms, “From tracking the number of echocardiograms that have been done, in which areas, to undertaking routine audits, the entire process is much faster and more accurate, enabling constant assessment of patient pathways.”

Continual service improvement is being delivered; for example, the Trust is using the Pacing module to document the implementation of pacemakers, and has recently implemented a dedicated Valve Clinic module that is providing an essential template to support the innovative, physiologist-led clinic designed to reduce waiting lists.

From streamlining processes for patients admitted for invasive diagnostic procedures to reducing patient visits through the introduction of the valve clinic, the Cardiology Unit continues to explore the power of McKesson Cardiology™ to drive continual improvements. The benefits are clear, as the Trust was recently named the best performing Cardiology and Hyper Acute Stroke Unit (HASU) in the UK.

Dr. Elkington concludes: “We have been delighted with the McKesson cardiovascular system. It has had a very clear, positive impact on the cardiology service at the Royal Berkshire Hospital.”


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"From tracking the number of echocardiograms that have been done, in which areas, to undertaking routine audits, the entire process is much faster and more accurate, enabling constant assessment of patient pathways"

Catherine Townsend

Echo Lead, Royal Berkshire NHS Foundation Trust

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