Nottingham University Hospitals redesign pathway for heart valve disease patients
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 processing.”
“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 surveillance.”
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.”