Nottingham University Hospitals redesign pathway for heart valve
28 February 2014
Nottingham University Hospitals (NUH) NHS Trust, has selected a
specialist Valve Clinic system from McKesson to redesign the
treatment pathway for patients with cardiac valve disease.
The Trust’s new physiologist-led Echo Valve Clinic welcomed its
first patients in September 2013 and uses the new system to store,
report and share echocardiogram imaging. The solution also enables
physiologists to make real-time referral decisions.
The system has halved the number of hospital visits for many
patients. It also is significantly relieving the strain on
cardiology clinics through reduction in the requirement for
follow-up appointments. This, in turn, is freeing up hospital
resources, and by enabling clinicians to see more cardiology
patients, improving operational efficiencies and patient care.
“The Valve Clinic system is hugely beneficial for everyone,” said
Dr. Michael Sosin, consultant cardiologist, NUH. “From a patient
perspective, it’s more convenient because many only need to visit
the hospital once. From a business perspective, it’s helping us
manage our resources and patient flow much more effectively.
Cardiologists are only required to see patients who have developed
symptoms or who need care more urgently, which in turn expands the
clinic’s capacity to see more patients. We also have increased
administrative efficiencies: clinicians and secretaries have seen a
reduction in the volume of clinical correspondence for dictation and
“We designed the new Valve Clinic module in close collaboration
with NUH,” said Maureen Gardner, McKesson clinical specialist, who
worked with NUH to customise the solution. “In addition to the
standard functionality of the McKesson Cardiology solution for
reporting and storing cardiac images, it is enhanced by a specific
template to support reporting of the heart valve abnormality and
NUH typically performs around 16,000 echocardiogram and 600
stress echocardiogram procedures each year – with numbers steadily
increasing. Because ultrasound is a primary diagnostic tool for
heart valve disease and a gatekeeper for surveillance of disease
status, demand for cardiology services has escalated. This in turn
has increased pressure on the speed of service and delivery of care.
Prior to setting up the new clinic, patients with suspected heart
valve disease were required to visit the hospital for an
echocardiogram and then return for a follow-up consultation another
day to determine their likely treatment pathway. This prevented
clinicians from quickly dealing with urgent cases.
Gardner said the system prompts the physiologist to ask specific
questions based on the type of heart valve problem and empowers them
to determine whether the patient should be referred to a clinician
for follow-up. “If a scan does not meet any trigger points, the
physiologist can send the patient home immediately,” she explained.
“At the moment, we only see patients with severe valve problems,
but with our early success, we may expand its use in the future,”
added Dr Sosin. “Every person we can manage in this manner
represents a patient that does not have to be seen in the cardiology
clinic. Someone else can then be seen sooner. Patients appear to
like it, and that’s very important to us.”