Areas of Cardiology Integration

1. Areas of Cardiology Integration Cardiac Longitudinal Record, Dissemination & Disease Mgt EKG Lab Echo Lab Lab Nuc. Lab Cath & EP Lab Other Cardiac Procedures IT Infrastructure (Security, patient Ids, user authentication) Ordering, Scheduling, Referral Charge Posting Billing

2. Echo • Echo WF+PIR (incl. MWL, gaps: physician scheduling mgt, not always HIS ordered, counter-indication/clinical decision, multi-stage tests) • Echo measurements with image links to reporting • Outbound Reports (states) with selected images Export (archiving images + report ?). • Lab Test Access

3. CathLab and EP • Access of Echo, Nuc, ECG, MR, CT, EP, Post-processing output (images, reports, measurements) • Lab Test Access • Cath WF-prep/collect + PIR (incl MWL, gaps: worse !, pre-cath, intra-cath, post-cath, NCDR input. • Cath WF-event log-tracking, time-synch • EP measurements, waveform • Cath WF-Reporting (define report content-Help from SCAI-ACC-ESC). • Access to previous Cath output • Outbound Reports (states) with selected images Export (archiving images + report ?) to Longitudinal record

4. ECG Lab • Access of ECG and reports enterprise wide and external to enterprise (status) • Time Synch • Scheduled and unordered, post acq ordering WF, Patient Info Reconciliation • Critical value notification, clinical context, audit trail. • Charge capture (save a buck)

5. IT Infrastructure • Enterprise User Authentication (single sign-on, multiple systems and enterprise access) • Patient ID Cross-referencing (patient ID/MRN linkage between hospitals, small practices). • Retrieve Info for Display(RID) - Inbound and Outbound (quick simple view, non-cardiac reports, still images, documents). • Retrieve motion images for Display (Inbound and outbound, non-diagnostic ?) • Consistent Time + special cardiac care episode events usage definition. • Patient Synchronised Apps (local and server) • Audit Trail (for Privacy, cross-domain, modality, central repository) • Consistency of PIR across verticals

6. Scheduling, Ordering, Referral • Multi-ordering patient care plan mgt, order external (rad, lab, drugs, transfer, etc.) + Discharge mgt. • Prerequisite checking (labs, drugs, insurance) • Patient location/tracking/transport • Inventory management (from Cath, Nuc.EP,) • Room/equipment availability (link to ordering) • Physician & staff tracking, notification. • Referral communication/authorization with/from referring physician

7. Longitudinal Record • Critical value notification, clinical context, audit trail. • Episode definition and linkages (integration with specific WF) • Cross-episode/encounter linkage and filtering query/retrieve from LR • Feeding in LR patient info from practices • Feeding/exporting with Media Interchange • Feeding in LR patient info from inpatient cardio • Quality, Guidelines Mgt - RetrievePocket Guidelines for Display • Export to national outcome registries

8. Short List • Echo WF+PIR (incl. MWL, gaps: physician scheduling mgt, not always HIS ordered, counter-indication/clinical decision, multi-stage tests) • Cath WF-prep/collect + PIR (incl MWL, gaps: worse !, pre-cath, intra-cath, post-cath, NCDR input. • Access of ECG and reports enterprise wide and external to enterprise (status) • Patient ID Cross-referencing (patient ID/MRN linkage between hospitals, small practices). • Retrieve Info for Display (RID) - Inbound and Outbound (quick simple view, non-cardiac reports, still images, documents). • RetrievePocket Guidelines for Display • Audit Trail + Consistent Time (for Privacy, cross-domain, modality, central repository)