Feature | May 19, 2011 | Dave Fornell

Silos Being Abolished With Current Generation CVIS

Only a few years ago, separate software systems without a common interface were the industry standard to manage electrocardiograms (ECGs), hemodynamic monitoring systems in the cath lab, picture archiving and communications systems (PACS), electrophysiology, cardiac ultrasound and other areas of cardiac specialty.

“They all used separate silos that did not talk to each other and they all used a separate workstation,” explained Rik Primo, director of marketing and strategic relationships, image and knowledge management, Siemens Healthcare.

However, over the past five to six years, Primo said all of these cardiology data sources have been consolidated into one IT system. These unified systems are referred to as cardiology PACS (CPACS), cardiovascular information systems (CVIS) or cardiology image and information management systems (CIIMS). They allow all the cardiology department data to be stored in one location and make it accessible on any Web-enabled computer. For physicians who work between two or more hospitals, these newer systems have greatly simplified access to images and reports, and allow them to work from any location, rather than needing to store work on memory sticks or CDs.

“It’s the end of the ‘best of breed’ individual modality systems – it’s just not efficient,” said James Poehlmann, marketing manager, Fujifilm Medical Systems.  He agrees all CVIS are migrating to enterprise-wide systems.  Hospitals can now purchase a central cardiology PACS and then attach various add-on modules for additional modalities, such as echo, ECG, CT, nuclear, advanced visualization, hemodynamics, etc.

Other Trends in CVIS

Over the past six years there has been a movement away from dictation toward structured reporting. The advantage is that all terms and definitions are consistent from patient to patient, allowing data to be mined for specific information. The data might be used to assess staff workflow efficiencies, examine which treatment options offer the best outcomes, or for future studies of specific patient populations or disease states years after the data is collected. The increasing need to efficiently collect and send large amounts of data to a growing number of clinical registries is also prompting  adoption.

“I think the biggest trend is an increased adoption of structured reporting, which is being driven by additional registry requirements,” said Robert Baumgartner, RN, director of product marketing for medical imaging, McKesson Provider Technologies.

He also sees other trends in the market. There has been an increased push to integrate electrocardiogram (ECG) waveform and reporting management into CVIS. Baumgartner has seen a push to integrate or link radiology PACS into the CVIS, since many hospitals do not have separate/designated magnetic resonance (MR), computed tomography (CT) or nuclear imaging systems for cardiology. The price for CVIS is also dropping. As competition between numerous vendors entering the CVIS market has heated up over the past few years, in addition to the lack of funding due to the economy, Baumgartner said there is negative pressure on the market to reduce the cost of these systems.
Another major trend is connecting CVIS images and information with smart phones and iPads. Many vendors are introducing or developing interfaces with these devices.

Clinical decision support software is another trend entering CVIS. The software is supposed to act as a second set of eyes on clinical data as it’s entered. These systems draw clinical knowledge from an up-to-date evidence-based medicine database. Such systems can determine what information or diagnosis should be considered based on the ICD-9 codes entered into the patient’s report. It can red-flag values out of normal ranges or offer suggestions for a possible diagnosis or additional tests or images needed to confirm a diagnosis.

Workflow Efficiencies a Key Differentiator

Workflow efficiencies are the primary differentiators between CVIS systems. These features might include touch screen and bar code data entry versus manual keyboard data entry, structured reporting over dictation or fewer clicks to accomplish a task. Other features might include interactive whiteboards and software to help speed data migration to registries.

Ensure the System Meets All Users’ Needs

In the cath lab, it is important to determine which subspecialties are using the lab and if the CVIS being considered offers those modules. Many cardiovascular cath labs are shared by electrophysiology, neurology, interventional radiology and vascular surgeons performing peripheral cases. Hybrid operating rooms may add several more specialties, including pediatric and adult structural heart and endovascular aortic repair.

“We are starting to see a lot more vascular procedures and more interventional radiology in the cath lab,” said Lee Harrop, director of cardiology product management, Merge Healthcare.

Baumgartner said CVIS are being expanded to include additional areas of cardiology, including electrophysiology, heart failure and cardiac ultrasound, image and report management.

Comparison Chart

This article served as an introduction for a comparison chart of cardiology department information systems used to enter, store and disseminate images and patient reports. These systems are referred to as cardiology PACS (CPACS), cardiovascular information systems (CVIS) and cardiology image and information management systems (CIIMS). The most recent PACS/CVIS chart can be accessed at www.dicardiology.net/comparison-charts?t=PACS/CVIS%20-%20Cardiology

Participants included:

Agfa Healthcare

Carestream Health


DR Systems

Fujifilm Medical Systems USA

GE Healthcare

Infinitt North America

Lumedx Corp.

McKesson Provider Technologies

Merge Healthcare

Novarad Corp.


ScImage Inc.

Siemens Healthcare

Related Content

News | Remote Viewing Systems | March 21, 2018
Cloud-based medical image management and teleradiology company NucleusHealth recently announced the commercial...
Exa PACS Helps Teleradiology Provider Increase Productivity 400 Percent
News | PACS | March 19, 2018
Nine months after the implementation of Exa PACS (picture archiving and communication system) from Konica Minolta...
Philips Launches HealthSuite Insights AI Platform for Healthcare
Technology | Artificial Intelligence | March 19, 2018
March 19, 2018 — Philips recently announced the launch of HealthSuite Insights, including the Insights Marketplace, t
Fujifilm Showcases Enterprise Imaging Portfolio and AI Initiative at HIMSS 2018
News | PACS | March 14, 2018
Fujifilm Medical Systems U.S.A. Inc. recently showcased its enterprise imaging and informatics solutions at the...
Technology | PACS Accessories | March 14, 2018
March 14, 2018 — Vital Images recently announced the release of Vitrea Connection version 7.0 with new features, incl
Siemens Healthineers Launches New Partners for Digital Ecosystem at HIMSS 2018
News | PACS Accessories | March 12, 2018
At the 2018 Healthcare Information and Management Systems Society (HIMSS) Annual Conference and Exhibition, March 5-9...
Siemens Healthineers Launches Next Generation of syngo Dynamics at ACC 2018
Technology | Cardiac PACS | March 09, 2018
March 9, 2018 — At the American College of Cardiology’s 67th Annual Scientific Session and Expo, March 10-12 in Orlan
News | Artificial Intelligence | March 08, 2018
Nuance Communications Inc. announced the signing of a multi-year strategic agreement with Partners HealthCare at the...
Digital Ecosystem is an open and secured environment for healthcare stakeholders that houses a range of digital offerings
News | Information Technology | March 05, 2018
At the 2018 HIMSS Annual Conference & Exhibition, Siemens Healthineers showcased new additions and updates to its...
Lumedx to Demonstrate Value of Advanced Analytics at HIMSS18
News | Analytics Software | February 28, 2018
Lumedx Corp. will show off the latest in advanced analytics and software solutions at the upcoming Healthcare...
Overlay Init