Brigham and Women’s Hospital in Boston conducted a pilot study of a Web-enabled computerized physician order entry (CPOE) system (another Stage 2 requirement) with embedded imaging decision support. In an effort to reduce the inappropriate use of medical imaging and improve quality of care, it was phased into clinical use between 2000 and 2010 across outpatient, emergency and inpatient departments. The study, published in the Journal of the American College of Radiology in February 2012, showed significant increases in meaningful use for electronically created studies (from 0.4 percent to 61.9 percent) and for electronically signed studies (from 0.4 percent to 92.2 percent) and the adoption of CPOE (from 0.5 percent to 94.6 percent).

Oklahoma Heart Hospital (OHH), Oklahoma’s first dedicated heart hospital, has excelled at creating quality outcomes through an integrated approach to patient care. To maintain this culture of quality, its team of more than 60 physicians, including interventional cardiologists, general cardiologists, cardiothoracic surgeons and electrophysiologists, practice a systematic process of patient care that includes high adherence to a set of core measures or indicators. Specifically, managing a patient’s risk for sudden cardiac death (SCD) is a critical piece of the care.

In the current era of healthcare reform and increasing requirements to follow appropriate use criteria, any technology that offers a basic yes or no answer to whether a patient should be treated or tested may have a major impact on healthcare. Fractional flow reserve (FFR) is a poster child example of this type of technology, which eliminates intra-observe variability and physician intuition and replaces it with a straightforward index based on clinical evidence. However, while FFR offers an accurate diagnostic tool to provide functional data that the human eye alone cannot see, its use has been limited by its cost and the time it takes to perform.

A recent review of data from the CathPCI Registry, part of the American College of Cardiology’s (ACC) National Cardiovascular Data Registry (NCDR), offers some insight into average, real-world D2B times.[1] For STEMI patients who arrived at an angioplasty-capable hospital, the average time from hospital arrival to treatment was 64.5 minutes. For patients requiring transfer to another hospital, the average time from arrival at the first hospital to treatment was 121 minutes.

There has been much discussion about how use of transradial access may help reduce costs by cutting hospital admissions, length of stay and observation periods, while also reducing bleeding complications and the need for transfusions. Few centers could offer hard numbers showing these savings, however empirical evidence is now surfacing that these statements are true. The numbers show that transradial programs are impacting several hospitals’ bottom lines.