Optimizing the interventional cardiology facility: Services integration in routine workflow

Objectives: Integration of administrative and clinical data, imaging, and expert services, although challenging, is a key requirement in contemporary interventional cardiology facilities (ICF). We propose a workflow-oriented hybrid system to support the ICF and investigate its feasibility and effectiveness in a referral medical center. Methods: We have developed a Java-powered hybrid system (NefCARDIO), able to support over web synchronous and asynchronous data management, real-time multimedia data felemonitoring and continuous telementoring. Data regarding procedural rates, treatment planning and radiation exposure were collected over a two-year period of routine NetCARDIO implementation (July 2002 to June 2004) and compared with data from an immediately preceding period of equal duration (January 2000 to December 2001). Results: During the NetCARDIO period, 163 ± 17 coronary procedures per month were performed vs. 77 ± 15 during the control period (p < 0.001). Percutaneous coronary intervention was delivered 'ad hoc' in 88% of eligible patients vs. 45% (p <0.001). Mean fluoroscopy time per coronary lesion treated decreased from 594 ± 82 s to 540 ± 94 s (p < 0.001). Annual radiation exposure of expert interventionists was decreased by 22%. Electronic storage significantly reduced archiving costs. Conclusions: Real-time multimodal services sharing combined with powerful database capabilities is feasible through a web-based structure, significantly enhancing performance and cost-effectiveness of ICF. Further research is needed to promote integration of additional data sources and services.