CardioCard Kit - bei Legon Informatik

Life Saving Decisions
Anytime, Anywhere
Our goal is to develop the marketing, training and consulting
aspects of CardioServices, the way cardiologists in larger
hospitals will document all of their medical processes.
Because of the niche character of cardiology we will aim
at the global market.
CardioServices will be based on a system which was
developed during the last ten years and is used for the
reporting of all examinations and interventions in the
Cardiology Department at the University Hospital of Basel,
Switzerland.
Visit us on: cardioservices.us
Life Saving Decisions
Anytime, Anywhere
Cardiological Patient’s Record –
also over the iPhone
In the Cardiology Department at the University
Hospital of Basel, the patient’s electronic records
are actualized today.
After every heart examination, the acquired data
and doctor’s judgement are automatically brought
together in a full report.
The reports are available to the patient and accredited
others, on paper, on the CardioCard and, as of recently,
also on the iPhone.
Visit us on: cardioservices.us
Overview CardioCard
Modalities IHE
(technical implementation)
CATH
– Hemodynamic Recording (HL7 and
DICOM compatibility)
Supplier: Siemens
ECG
– PIX/PDQ – MPI (Master Patient Index)
– HL7 (A01, A02 and A19) – Messages for
Patient Identity Management
– Retrieve ECG for Display
Procedures
Echo
– DICOM (.dcm)
– Picture Archiving and Communication System
(PAC) for dcm and pdf (ISO ISO 32000-1:2008
and PDF/A in ISO 19005-1:2005)
EP
ME/CT
– DICOM
Modules
(View by system users)
Examination type and report
for practitioners diagnosis
and intervention
CATH left
CATHerization left and right
CATHerization left
PTCA
Cardiac CATHerization right
PTCA
CATH right
ECG
HolterECG
Echo
EPS
ICD Implantation
ICD Control
PMR Implantation
PM Control
CMR
MPS
RNV
Clarification
Nuclear
– DICOM
Pysicians Report
miscellaneous
Conference
Entry Examination
Council
Level 1
Rest ECG
Stress ECG
Event Monitor
Holter ECG
Stress Echocardiography
Transesophageal Echocardiography
Transthorakale Echocardiography
Electrophysiology Studies
Electroconversion Overdrive
Radio Frequency Ablation
ICD-Revision
ICD-Implantation
ICD Change
ICD Check and Shock
ICD Check
PM Implantation
PM Change
PM Revision
PM Check
CMR Report
Myocardial Perfusion Szintigraphy
Radionuclidventriculography
Heart Insufficiency Consultation
Heart Muscle Biopsy
Postoperative Consultation
Clarification Consultation
Cardiological Report
Mitral Valve Repair
Electro-Conversion
Tilt Table Testing
ASD/PFO Closure
Cardial MRI (CMRI)
Rhythm Consultation
Council
Private Consultation
Conference
Entry Examination
Patient Registration
SCAN
Council
Vitien Consultation
Registration
SCAN
Level 2
Level 3
Systemeigenschaften Legon CardioCard
1. Richtige Richtung
4. Verlässliches Funktionieren
In der Kardiologie des Universitätsspitals Basel ist das Elektronische
Patientendossier bereits heute Wirklichkeit.
Enthält 70’000 Patientendossiers – Jährlich kommen ca. 8’50010’000 neue Patientendossiers hinzu
Integriert in State-of-the-Art Infrastruktur (IBM Archiv, Portal, etc.)
Enthält 400’000 kardiologische Untersuchungen – Jährlich
kommen ca. 70’000 neue Untersuchungen hinzu
Integriert in IHE
Patienten-Plattform mit HF-Monitoring und Patienten-Konsens
(Ende 2009)
Sicheres Finden der betroffenen Patienten bei Medtronic-Rückruf
5. Zuverlässige Wirkung
2. Höchste Präzision
Steigende Berichtsqualität
Legon CardioCard ist eine Individual-Entwicklung die genau auf
die betrieblichen und diagnostischen Bedürnisse der Kardiologischen Abteilung des Inselspitals abgestimmt wird
Sinkende Berichtskosten
Individualentwicklung zu den Kosten eines Standardsystems
Legon CardioCard deckt über 50 verschiedene Untersuchungsund Eingriffstypen ab
6. Grösster Nutzen
3. Schnellstes Tempo
Nach jeder Herzuntersuchung werden die erfassten Daten und
Beurteilungen der Ärzte automatisch zu einem Bericht zusammengefasst.
Die Berichte stehen dem Patienten und allen Berechtigten
sofort zur Verfügung: auf Papier, auf der CardioCard
und seit kurzem auch auf dem iPhone.
Einführungsdauer (Konzeption, Entwicklung, Test, Schulung) für
neue Module ca. 3-6 Wochen
Jeder Kardiologe spart täglich bis zu 1 Stunde Zeit mit der
Berichterstellung
Täglich hunderte von Berichteinsichten aus anderen Abteilungen
Weniger Untersuchungstermine für Patienten
CardioCard-Szenarien
Übersicht
Szenario 1
Szenario 2
Szenario 3
Szenario 4
Szenario 5
Patient mit Patientenkarte
Notfallarzt
Hausarztportal
Hausarzt und Kardiologe interaktiv
Patienten-Plattform
Realisationsstatus
1
1
Das Hausarztportal
Hausarzt meldet Patienten für kardiologische Untersuchung am USB online an
Untersuch Hausarzt
Anmeldung einer Untersuchung
Patient mit Anmeldebestätigung
Hausarzt meldet Patienten für kardiologische Untersuchung am USB online an.
2
2
Hausarzt und Kardiologe interaktiv
Patient kommt mit Beschwerden zum Hausarzt, Sofortabklärung auf kardiologische
Auffälligkeit mit einem Experten des USB
Untersuch Hausarzt
einfaches EKG
Kardiologe erläutert EKG
Das CardioCard-System macht es möglich,
dass Hausarzt und die USB-Kardiologie
direkt in Kontakt treten können. Kommt
ein Patient mit Beschwerden zum Hausarzt,
kann das EKG sofort vom Experten des USB
auf kardiologische Auffälligkeiten hin interpretiert werden. In einem Pilotprojekt hat
dies das USB bereits mit einer Basler Kardiologie-Praxis realisiert. Knackpunkt bleibt
indes: Bisher fehlt ein Abrechnungsmodell
mit den Krankenkassen.
Patient mit Anmeldebestätigung
3
3
Spitzensportler mit USB-Stick
Der Sportarzt kann in seiner Praxis jederzeit das aktuelle USB-Kardiologiedossiers des zu Untersuchenden abrufen.
Der Sportler bekommt sein Dossier für den Auslandswettkampf auf dem USB-Stick oder der CardioCard ausgehändigt.
Untersuch beim Sportarzt
Belastungs-EKG
CardioStick
CardioCard
Sportarzt mit Bericht
4
4
In der Kardiologie Basel realisierte Telemedizin
Nach der Fernübermittlung des EKG durch FRED aus dem Rettungswagen kann die Expertenmeinung des
nicht-diensthabendem USB-Spezialisten mittels SEMA eingeholt werden.
Kardiologischer Notfall
FRED Defibrilator und EKG-Übertragung
Vorbereitung der Notfallaufnahme
K-Spezialist gerade nicht im USB
Kardiologie-Spezialist des USB beurteilt den Fall von
unterwegs mit dem iPhone.
Ambulanz trifft im USB ein
5
4
In der Kardiologie Basel realisierte Telemedizin
Für Notfallpatienten geht es oft um wenige Minuten, die über Leben oder Tod
entscheiden. Hier hilft die durchgehende Vernetzung des Cardiocard-Systems:
Der diensthabende Arzt will bei einem komplizierten Fall den Rat eines abwesenden Kollegen einholen. Der benachrichtigte Kollege betrachtet das mit FRED
ans USB gesendete EKG auf seinem iPhone und berät den diensthabenden Arzt.
Als der Notfallpatient kurz darauf ins Spital eingeliefert wird, ist schon alles für
ihn vorbereitet.
6
5
CardioVest
Patient mit Herzbeschwerden trägt ein mobiles EKG-Gerät. Die Daten vom EKG werden ständig über das mitgetragene iPhone an das Spital gesendet. Vom Spital wird der Patient rund um die Uhr überwacht.
Herzpatient bekommt die CardioVest mit
den eingebauten EKG-Sensoren
Patient mit iPhone
Während der Patient seinem Berufs- und
Freizeitleben nachgeht...
1
201nftsu
Zukenario
Sz
...wird sein Herz von einem professionellen Team
im Spital ständig überwacht
7
Realisationsstatus
Patient
Hausarzt
Spitalarzt
Spital
1
Technik
Patient mit
Patientenkarte
*
*
*
*
2
Technik
Notfallarzt
*
*
*
3
*
Verbesserung:
sofortiger exakter
Terminvorschlag
HausarztPortal
*
*
4
Hausarzt und
Kardiologe
interaktiv
Business
*
Business
Technik
Business
Technik
Nur Schiller-EKG
*
5
PatientenPlattform
*
Business
Technik
Business
*
Momentan: unentgeltlicher Service
8
Legon Entwicklung
Patientenplattform
Heart Failure Monitoring Application
(HFMA)
186
Mobile Doctor
LifeVest
CardioCard Tomorrow
Today
Doctor-patient communication
(Family doctor “GP” / hospital doctor /
cardiologist)
Doctor access
cardio records through
mobile computer
Analysis
-Scale
-Oxygen measurement
AMBULANCE
Ambulance is underway
to the client
Legon’s patient record
CardioCard Tomorrow
General client information / coaching
(Gotrybe)
Medgate
Doctor-patient communication
(Family doctor “GP” / hospital doctor /
cardiologist)
Doctor access
cardio records through
mobile computer
Patients Platform
-Weight Control
-Sports, Activities
-Patient Consent
186
Analysis
AMBULANCE
Ambulance is underway
to the client
Legon’s patient record
Project Variables
Most projects have four parameters – time, cost, features and quality. Trying to fix all these parameters at the outset
is impractical and is the cause of many common problems.
Traditional Approach
Features
DSDM Atern Approach
fixed
Time
Cost
Quality
Quality
Time
Cost
variable
Features
MEMORANDUM FOR INFORMATION
11 July 2008
SUBJECT: CardioCard Capabilities Summary for US Marketing
SUMMARY
Installation of this card into the United States system will most greatly benefit the Emergency
Medicine community in the long term and Cardiologists in the short term. Cardiologists would be
able to stream-line their reporting procedures as well as keep all of their patient’s information on an
easy-to-access database. These electronic files also make the data much easier to produce some form
of report for the patients to take with them. CardioCard allows ER doctors the luxury of assimilating
critical information about their patients prior to the patients’ arrival in the hospital. Currently, people
requiring emergency care in acute situations can, in the best situation, only present the physicians
with a fragmented personal medical history. CardioCard will dramatically reduce the risk of medical
negligence presented by this current situation. DoD first responders are other potential customer’s
for the benefits of CardioCard, although modification would be needed.
INTRODUCTION
CardioCard was created in Basel, Switzerland in the Spring of 2000 with a research and start up
cost of $4 million. Since then it has been running on PCs in the various sections of Basel’s
Cardiology Department. It began with patient requests to obtain medical records of their recent
appointments and exams. Echocardiograms were the first to be automated and saved, but in 2003,
CardioCard reached out to further record formats, to include EKGs and other diagnostic tests and
procedures. It also began creating resolution between different doctors on the patient’s current
situation. This initiative works via integration platforms between hospitals, meaning it does not
change the hospitals current records, but acts as a satellite component that integrates different medical
records into an individual, full, picture. Currently, the card is limited to cardiothoracic procedures
and records, but hopes to expand into other specified fields.
COST, DEMOGRAPHICS, AND LIMITATIONS
Health care cost in Switzerland is paid through split funding. Each canton pays 1/3 of the health
care cost, the patient pays 10-20% of direct cost (5-6 weeks in hospital cost $5-6,000 total), and
insurance pays the rest. This amount depends on the company, the patient, and what information
insurance company can see. This is dictated by the patient.
However CardioCard is entirely funded by the involved cardiologists. Approximately 38,000
people are on CardioCard with 7,000 joining a year. Currently there are more than 400,000 reports
stored within the system. The genesis of and maintaining aspect of CardioCard lies in the
demographics of the prevailing cardiac patient population, which is over 60 years of age. Elderly
people balked about having their records on the internet; 80% would rather have it in CardioCard
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1
format, i.e. a hard copy. This perception will change as patients realize that their medical records are
encrypted and as safe from tampering as a bank transaction. Once this demographic shift occurs in or
around the year 2015, CardioCard will meet its demise as a card and morph into an online access
based system for the patient.
Pediatric (under 18) cardiology is not currently supported on CardioCard. Yet research for
GoTryBe (from the National Obesity Institute, 2006) purports a gruesome foreshadowing of the
future; today’s generation of children has a shorter life expectancy than their parents. This is
prevailingly due to poor diet and exercise, causing a majority of undue duress on the liver and heart
systems.
CURRENT PROGRAM USE
“Instead of vague statements hedged about with qualifications, clear entry paths now lead to
unequivocal
interpretations,”
-Senior physician Prof. Dr. Stefan Osswald, on CardioCard’s application
Currently, Basel Hospital medical supervisors and senior physicians use CardioCard as their main
information entry point. They use this web-based database to write and store all of their files on each
cardiac patient they see. It also allows them easy access at the end of the day to assess and discuss
dozens of patient files which are projected onto the walls of the meeting room. CardioCard also has
the ability to subject the data collected from their patients to a statistical comparison. This offers
medical staff an important tool for checking and assuring the quality of the techniques they apply as
well as offer accessible information for ground-breaking research. In addition to this benefit, they can
dispense with a great deal of paperwork, as the CardioCard database is used to document medical
records and histories of individual patients and prepares ready-to-dispatch letters to their GPs and
specialists. This eliminates the need for hand-writing the reports, sending them to transcriptionists,
having the medical records department enter the file electronically and then having the report
evaluated by the physician. By allowing the physician to input the data immediately, rather than
receive it electronically a day or more later, the daily paperwork for each doctor has now been
reduced by at least half an hour per patient.
Another benefit CardioCard affords its physicians is its ease of accessibility outside of the
hospital. On-call physicians are able to look at the patient information via their iPhone (or other PDA
device) because the data is stored on an online database. EKG’s, old reports, etc can be accessed
from home without having to enter the hospital unless necessary. This time-saving, cost-cutting
aspect of CardioCard could most benefit other departments within the hospital.
For the patients, it provides them a hard copy of all of their most up to date medical records,
which include current medications, allergies, results of tests, physician remarks, etc. This hard copy
could be actual paper, a CD, or thumb drive the patient carries with them. As already mentioned,
once the stigma of electronic files lessens, patients would be given an access code to the
database—similar to a pin code for a banking website—to access their medical records wherever they
are.
Although CardioCard centers on the establishment of a new diagnosis and treatment concept,
the
software can also be used to control the scheduling of examinations and operations. It also integrates
the laboratories to which patients are allocated depending on their available resources. Its statistical
CardioCard_Paper-11-7-08.doc
2
components not only allow scientific verification of the efficiency of the selected forms of treatment,
but also evaluate the performance of individual teams. In addition, the program integrates the user
rights which control its access options
(http://www.legon.ch/sitelegon/sites/projekte/CardioCard/CardioCard_e.pdf, pg. 7).
The following heart examinations are captured on CardioCard (Modalities IHE, technical
implementation):
• CATH
• ECG (Electric potentials)
• Echocardiography (Ultrasound for diseases of myocardium and heart valves)
• EP
• ME/CT
• Nuclear
• Miscellaneous (Clarification, Physicians Report, Conference, Entry Examination, Council,
Patient Registration, SCAN)
A more detailed overview as well as a list of medical reports supported by the program can be found
in the appendix.
The user interface is simple to navigate. The physicians see a clearly structured template specific
for each test/procedure. CardioCard also offers the option of integrating special remarks and
comments into the overall assessment. However, only entries in selected pre-specified categories are
statistically evaluated. Such a stringent construct keeps physician entries succinct, allowing them to
focus on the patient instead of a verbose and somewhat uncommitted diagnosis. As Dr. Osswald
pointed out, “Look what people are doing. They’re reading and writing, but they’re not seeing the
patient.” Convenience via technology breeds increased redundancy in reporting and wasted time.
CardioCard ensures this does not happen.
CardioCard_Paper-11-7-08.doc
3
UNITED STATES MARKETING
Bottom Line
CardioCard has outstanding marketability in the United States. Its unique and desirable
attributes can only be fully understood via its hands on “test or template” website. Here, international
users can access and try out the applicability of the product. Please visit the Legon website at
http://www.legon.ch/ or email Matthias Hediger, Chief Developer; hediger@legon.ch for access to the
test site at: https://62.167.16.51/legon2/anmelden.
Business Perspectives; Marketing Points for the US
Value Creation
In systems like US Health Care that are plagued with problems, value creation will move
units toward profitability and satisfied customers. Hospitals can be considered business units. They
are an organization that provide a series of services to customers, or patients in this particular case.
The fundamental principle of value creation is that all decisions are made based on the amount of
value they add to the business unit. Specifically, the customer’s perceived value of their visit and the
revenue gained by the hospital must increase as a direct or indirect result of a decision. CardioCard is
a tool that will facilitate value creation within the Cardiology department of a hospital. This system
contributes to the overall value of the hospital in the following manner.
Most obvious is the time that CardioCard saves doctors and patients. CardioCard enables the
digital compilation of patient records into a central location. This location is in turn accessible by any
web-enabled device. Ease of accessibility allows doctors on-call to read patient data in-route to the
hospital or call in treatment from home, thereby reducing the amount of time a patient spends in the
hospital. Less time in hospitals equates to less resources used and increased value for the hospital and
patient. Patients value quick, effective treatment and spending as little time in a hospital as possible.
Waiting to see a doctor is simply frustrating.
This system creates value for the patient by reducing visits due to lost records, lowered
insurance expenses, a more positive hospital experience, and quicker treatment. Also, by allowing
full access to their own records, patients can then easily acquire second opinions or relay information
to family physicians. This method can also reduce the perception of ‘secrecy’ of medical results that
is common between physicians and patients.
Dictation is eliminated by CardioCard. By updating records immediately, there is no need for
transcriptionists. Since doctors must enter the information themselves, it encourages them to write
concisely and keep to the point. Information will contain more valuable content and less ‘filler’
thereby contributing to time saved since there is less to read and evaluate by other physicians. This
reduction in time spent allows doctors to spend their time in the most valuable way: with patients.
CardioCard adds value by increasing efficiency so that doctors may spend time with patients instead
of reading multiple reports. Treatment can be recommended on the fly through mobile devices,
eliminating costly travel times. Patients receive quicker, more effective treatment and have access to
their own data.
Information Technology:
The implementation of CardioCard is relatively simplistic. There are low hardware
requirements and the software is easily applied to legacy systems. The two foreseeable complications
involve the data templates and the medical machines. The hardware requirements for CardioCard
include, but are not limited to, an additional database server. Other hardware requirements will
CardioCard_Paper-11-7-08.doc
4
depend on the current capabilities of the target hospital. Presumably, most hospitals will already have
an Ethernet infrastructure and a web server. These legacy networks will sufficiently support
CardioCard with the addition of a database server. Information storage requirements are roughly 2040 GB for ten years of data.
CardioCard is a software based system that lets doctors and patients interface with medical
records through a web portal that displays query results from a database containing medical data
organized per patient. The data is entered via web templates resembling the paper copies doctors are
familiar with. These templates can be manipulated during implementation to conform to the desires
of the physicians. Data entry is restricted as much as possible to create uniform entries. This is done
primary through drop-down menus and selection boxes. Free text entry is strictly limited.
The implementation of CardioCard has two approaches: full or modular. The approach
depends mostly on the circumstances of the hospital. For example, a hospital not entirely convinced
of CardioCard’s effectiveness may require a full implementation so that they do not pull funding and
cancel the project due to dissatisfaction. The full implementation is more likely to disrupt hospital
activities than the modular approach. But that is at the discretion of the hospital. The program is
fairly easy to learn and requires little training for doctors. Regardless, implementation is relatively
simple after templates are established and is flexible enough to meet the requirements of the hospital.
Choke Points and Solutions
Insurance/Medicare: As many of the cardiac patients in the US are at least somewhat reliant
on Medicare, it is important to make sure that this software is Medicare-friendly. This would require
assurance that there is enough documentation for each test/procedure to fulfill the Medicare
requirements. To meet these requirements, a Medicare specialist could overview the templates to
ensure enough information. A delicate balance must also be maintained as far as patient privacy.
Insurance companies as well as Medicare would not be given passwords to access the files and would
continue to rely on what the physicians offered as proof of why a certain test/procedure was
performed.
Inertia: One of the bigger problems facing Switzerland, and likewise the US, is the fact that
most physicians and hospitals do not want to change their standards of operation simply because they
are
comfortable already knowing one system—even if that system is not the most efficient. We must
show each organization how time-saving and cost-effective CardioCard is for all parties involved by
allowing each to personally interact with the system. This would be done more effectively in teaching
hospitals, as they already have to teach their systems to new people.
Stand alone Solutions between modules and specialties: Another potential problem at first
will be trying to have the different specialties (and perhaps even the physicians within a particular
specialty) agree on the way data is to be reported. Each hospital would be responsible for fashioning
their templates for each procedure/test so that there would be a consistency between each physician's
report. This obviously would take a lot of compromise and would force specialties to lose some of
their unique detail. Each department would pick a few attending physicians to decide on parameters,
and then all department heads would meet together to compromise between specialties. The Chief of
Staff would hold the highest power so as to eliminate an "uncompromisable situation."
US dependency on techs and nurses: As the US healthcare system depends largely on nurse (and
somewhat on technician) documentation, they would have to be incorporated in such a way in the
reporting process that they still had access to the test templates, but not have access to the physician's
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5
portion of the report. Perhaps limited passwords would be appropriate for the less subjective portion
of the exam (i.e., height, weight, BP, etc). An all-inclusive password would only be given to the
physicians—ensuring accuracy and licensure boundaries.
Information Technology: One drawback to CardioCard is its inability to handle old data.
Many hospitals will exhibit resistance because of this factor. It is possible to insert this information,
but the worst case is transcribing by hand thousands of records. This is an issue that must be
addressed on a case by case basis. If the hospital requires the inclusion of old data, it is recommended
they find a solution themselves, or face additional implementation costs. In some cases filling
CardioCard databases with old data may simply not be possible. The templates are another
foreseeable obstacle. This is due to the hospital staff, not the limitations of CardioCard. The hospital
department must agree universally what the template will look like and what information will be
included. This may prove difficult because of varying opinions. It may prove beneficial to have a
strong head inside the department that can force a decision. The third obstacle concerns the medical
machines themselves. Generally vendors are reluctant to reveal the source code needed to capture the
output data from those machines. There are several ways to acquire this code, some easier than
others. If the hospital plans to acquire new machines, it is recommended that access to this source
code be part of the contract with the vendor.
CONTACTS IN THE UNITED STATES
“What can we offer? We can align the business need with actual IT capability in the cardiology
realm. This allows us to do the unthinkable; we can organize the competition in a way where value is
created for the PATIENT.”
-Hansjorg Lehner, CardioCard CEO
There must be a multi-pronged marketing front to effectively introduce CardioCard to the United
States. Three major groups must be targeted simultaneously; personally known cardiologists,
advertisement/business, and investors. In order to get the support of one group, the group must know
it is obtaining an advantage from the other two. In order to make this happen, we propose the
following contacts be integrated into the CardioCard venture.
Cardiologists
• Dr. Lindsay; madwilliec@aol.com and Dr. Foster (Knoxville, TN), entry via Jacqueline
• UMass Medical, entry via Chrissy
• Dr. Feit, Cardiothoracic Surgeon, retired; anatomy teacher (ETSU), feit@mail.etsu.edu
• Shane Barger’s cardiologists (VA)-specifics pending permission for an email via Chrissy
• Danielle Stackhouse, Urologist/Internist (Tulane, DUKE), entry via Chrissy
• Vanderbilt, entry via Fangbai Wu; zfww2@goldmail.etsu.edu
• California, entry via Gregor
Advertisement, Business, Investors
•
•
•
•
•
iPhone via Hansjorg Lehner; lehner@legon.ch
GoTryBe via Bill Joyner; JOYNERW@mail.etsu.edu
o Nike (via GoTryBe)
o Atlanta (via GoTryBe)
Kevin Hall, Account Relations (Seattle, WA); kbh4369@gmail.com
Bill O’Hara, business contact (Washington DC); bill.ohara@gmail.com
Jacqueline Vidosh, US Marketing (Johnson City, TN); jvidosh1@gmail.com
CardioCard_Paper-11-7-08.doc
6
•
•
Christina O’Hara, US Marketing (Johnson City, TN); chrissy.ohara@gmail.com
Welch Allyn Inc. (via Jacqueline)
Corporate Headquarters
4341 State Street Road
Skaneateles Falls, NY 13153-0220
USA
Tel: 1.800.535.6663
Fax: 1.315.685.3361
REACHBACK CAPABILITIES: SWISS POINTS OF CONTACT
Cardiologists:
• Stefan Osswald, Basel Hospital Cardiologist, CardioCard Founder; sosswald@uhbs.ch
• Gregor Leibundgut, Basel Hospital Cardiologist; gleibundgut@uhbs.ch
• Patrick Hunziker, Basel Hospital Cardiologist; phunziker@uhbs.ch
Legon POCs:
• Matthias Hediger, Chief Developer; hediger@legon.ch
• Hansjorg Lehner, Chief Executive Officer; lehner@legon.ch
• Vernessa Riley, Director of Communications and Marketing, English Speaker
vernessa_rf@hotmail.com
• Urs Rutschi, Director of Art and Design; urs@rucci.ch
• Stefan Hubeli, Chief Financial Officer; stefan.hubeli@gmx.ch
• Yu Guang, Consultant, Asian Development; guang.yu@hispeed.ch,
http://www.legon.ch/china
• Till Ramstein, Graphic Designer; graphicdesign@tillramstein.ch
CONCLUSION
CardioCard is a well developed and adequately funded Swiss project that has great potential to
extend its services to other countries. This statement absolutely includes the United States if complete
translation of the program occurs and the correct entry points open.
Please direct any comments or questions about this article to the below authors.
CardioCard_Paper-11-7-08.doc
7
KEVIN HALL
Account Relations
kbh4369@gmail.com
CHRISTINA S O’HARA
US Marketing
Chrissy.ohara@gmail.com
JACQUELINE VIDOSH
US Marketing
jvidosh1@gmail.com
CardioCard_Paper-11-7-08.doc
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P O R T R A I T ST E FA N O S SWA L D
Am Puls der Zeit: Das iPhone zwischen EKG und Stethoskop
Stefan Osswald ist ein Überflieger. Während die Schweiz noch über E-Health diskutiert, hat beim Kardiologen die Zukunft bereits begonnen.
TExT: PETER RéVAI
lichtes Raster für das therapeutische Vorgehen gebracht werden können, kam er – inzwischen zurück am Basler Spital – mit seinen
Kollegen darauf, eine eigene Software für den
klinischen Einsatz entwickeln zu lassen. Sie
sollte bei Fallbegutachtungen Infos für eindeutige Interpretationen liefern.
Foto: Universitätspital Basel
Stefan Osswald und seine Kollegen nutzen die erste Schweizer Medizinanwendung für das iPhone.
a Freie Zeit bleibt dem vierfachen Familienvater und Mediziner Stefan Osswald bei seinem Beruf wenig. Wohl auch deshalb entwickelt der renommierte Basler Kardiologe
ständig Ideen, wie seinen Patienten und Mitarbeitern geholfen werden kann, um Zeit zu
sparen. In der Herzmedizin geht es oft um
wenige Minuten, die über Leben oder Tod
entscheiden. So hat der Technologie-Fan
dieses Jahr die erste Schweizer iPhone-Applikation als Pilotprojekt initiiert. Damit sind
seine Mitarbeiter in der Lage, jederzeit und
überall Elektrokardiogramme (EKG) sowie
komplette Krankenakten ihrer Patienten
einzusehen, ohne Zeit für den Weg zurück ins
Spital zu vergeuden. Osswald geht davon aus,
dass das Smartphone wie das Stethoskop zur
Grundausrüstung jedes Spitalarzts werden
wird, da es neben Patienteninformationen
auch medizinische Online-Hilfe bieten wird,
was das Mitschleppen von Checklisten und
Nachschlagewerken überflüssig macht.
IT hilft Kardiologen
Auf den Geschmack der Informatik ist Osswald 1988 als Assistent an der Uni Zürich
gekommen, als er den Apple-Macintosh und
Zur Person
Stefan Osswald führt eine der vier kardiologischen Abteilungen des Basler Universitätsspitals. Er wurde vor 49 Jahren in der Rheinstadt
geboren und hat auch da seine Studien absolviert. Danach leitete er von 1992 bis 1993 ein
Forschungsprojekt an der Harvard-Universität in
Boston. 1994 hat er die klinisch-elektrophysiologische Abteilung am Universitätsspital Basel
gegründet. Seit 1998 ist er Leiter des Arrhythmiebereichs der Kardiologischen Klinik und seit
2004 Vorstandsmitglied des Bereichs Medizin
des Universitätsspitals Basel.
das Internet mit seinen medizinischen Datenbanken schätzen lernte. Bei seinen Herzforschungen in den USA fielen so viele Daten
durch die Diagnostik-Apparaturen wie EKG
oder elektrisches Mapping von Herzrhythmen an, dass sich die Resultate nur mit Hilfe
der IT realisieren liessen. Der anschliessende
Schritt, sie miteinander zu vernetzen und in
Dossiers zu bündeln, war fast schon zwingend.
Da die Daten relativ leicht in ein vereinheit-
Von der Idee zur Gesamtlösung
Inzwischen ist die Lösung ein ausgewachsenes E-Health-System mit über 40 Modulen.
Die von der Aargauer Legon entwickelte
Lösung basiert auf einem zentralen ServerKonzept. Sie hat die Ärzte bisher rund 3,5
Millionen Franken und Tausende von
Arbeitsstunden gekostet. Seit dem Jahr 2000
ist die Lösung Cardiocard im klinischen Einsatz. Täglich begutachten die Ärzte Patientendossiers, die an Sitzungen an die Wand
projiziert werden. Die Lösung liefert auch statistische Auswertungen, so dass sie gleichzeitig wissenschaftlichen Zwecken sowie der
Qualitätssicherung dient. Dank ihr entfällt
pro Arzt täglich rund eine Stunde Schreibarbeit, da die Krankengeschichten automatisch
generiert und in versandfertigen Briefen für
Fach- und Hausärzte bereitgestellt werden.
Inzwischen gibt es Schnittstellen für externe
Ärzte und Partnerkliniken ebenso wie einen
automatischen Terminplaner für Untersuchungen und Operationen. Dank der Software tragen bereits über 1000 Patienten ihre
Krankengeschichte digital bei sich. Als
nächstes plant Osswald, dass auch seine Patienten ein iPhone ständig auf sich tragen,
damit im Notfall ihr Standort via GPS ermittelt werden kann. Zudem könnte ein integriertes EKG die Bilddaten übermitteln. Da
die IT-Welt der Schweizer Spitäler durch
Eigenentwicklungen geprägt ist, versucht
Osswald, mit Cardiocard im Ausland Fuss zu
fassen. Gemeinsam mit dem Software-Hersteller wird die USA angepeilt. Man kann
davon ausgehen, dass die erwarteten Gelder
weiteren Ideenumsetzungen des Professors
dienen werden.
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