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“We went one step further and created a dynamic ECG system”

Ramesh Kumar Yadav, Head-IT, Aditya Birla Memorial Hospital, and HHH (Healthcare) Award 2017 winner, discusses developing a PACS-based dynamic ECG system to improve efficiency and business. By Satyaki Sarkar

Ramesh Kumar Yadav started his career as a software programmer over 23 years ago and has since worked with companies like Sanghi Group of Industries, Asset International, Chandrala Financial Services, and Seth Nandlal Dhoot Hospital. He has spent the majority of his career working in the hospital segment and has handled several projects focused on developing IT infrastructure, IT software, EMR, MIS, ERP, SDLC, CPOE, HIPAA, and more. He recently won the HHH (Healthcare) Award 2017 for his work in SMAC (Social, Mobile, Analytics and Cloud). Here, he speaks to us about integrating 12 ECG machines into his PACS system and turning it into a dynamic system, thereby creating a seamless end-to-end workflow, increasing data accuracy, reducing processing time, and increasing efficiency.

Project details
“Increasing productivity and improving patient outcomes both depend upon fast physician access to patient data. At ABMH we’ve been working to digitise the entire process of health records monitoring and diagnosis. As part of this, we worked on integrating an ECG machine manufactured by GE into our system. Unlike older models, if you connect the machine to a computer not only does it give you the ECG printouts directly, it will even give you the complete video file of the ECG. However, we wanted to go one step further by turning it into a dynamic ECG system. We consulted our PACS team and the GE team to see if there was a way for the video to be made dynamic instead of static. The PACS system has several file structures, for example, a CT scan uses a file structure known as CT, X Rays use CR, and so on. The PACS team gave me an encapsulated PDF, which is the format for ECGs, and based on the server specifications presented to us by the GE team we procured a prerequisite server for capturing ECG study storage, forwarding and retrieval and integration with PACS. We then hooked up the ECG machine to the server so that now whenever the ECG study is done it will include all the patient details, including the MRN number and the doctor in charge. Additionally, the scheduling of patient treatments is also viewable via the ECG machine itself.”

An upgraded offering
“In an emergency we can now use the integrated setup to make payments for an unscheduled ECG study by opening the PACS system server via the ECG machine, and click on the reconcile button to attach the ECG to the patient. This will ensure that  reports as well as the details of the payments to the patient are tallying. Additionally, physicians earlier needed to refer to a hard copy of the patient’s medical records before performing any kind of treatment or operation. Now, with the patient’s entire medical history and records available online, on the PACS system itself, the 12 lead ECG machines that we have can display the data directly by accessing the PACS server. Whenever doctors need to check anything, they can look it up online without needing to maintain any physical copies.”

Overcoming challenges
“The biggest challenge we faced was integrating the ECG workplace with the PACS system so as to make the data flow seamless and interconnected. The order scheduled in PACS was not reflecting in the worklist of the ECG machine due to location field being non-mandatory in PACS system and was left blank. However this was a mandatory field in ECG worklist side as there were multiple ECG machines. Hence, we incorporated the entry of the location in the PACS side and the worklist on ECG started getting populated with the study orders.”

Benefits
“Post-implementation the organisation’s efficiency improved vastly, as this completely eliminated the need for paper-based hard records, which would earlier be maintained manually and be frequently misplaced. As a result, the procedures and diagnosis of patients became a lot more streamlined, faster, and easily traceable. Every four hours a mail is also sent out detailing the number of patients admitted, the charges they would be incurring, and how much deposit has been paid. This mail helps ensure business continuity in the time of any potential crash or loss of data, and is a proactive way of implementing a dynamic backup system that works on a real time basis.” 

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