Publication Healthcare Journal of New Orleans | Author Anna Thibodeaux | Date Sept/Oct 2015
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Marketed as “enabling cardiovascular intelligence,” the OMS Cardiology Suite designed by cardiologists for cardiologists is hitting the national market. As with most inventions, this cardiology-specific EHR and software arose from frustrated cardiologists who discussed the many challenges they and their patients faced in their industry.
“Without a specialized heart database, cardiologists would often find themselves spending a lot of time scanning paperwork and digging through graphs and health records to try to evaluate a patient’s condition,” said Dr. Vinod Nair, cardiologist and president of Objective Medical Systems (OMS) in Houma. “If a patient had been treated at a different hospital or medical center, important pieces of their history — prescriptions they had taken, even the outcomes of surgeries — were sometimes inaccessible altogether.”
Nair and his medical group – Dr. Peter Fail, Dr. Richard Abben, and Gary Chaisson – collectively with more than 180 years experience in cardiology, developed what they feel is a solution – a cardiovascular-specific EHR (electronic health record) software called OMS Cardiology Suite.
In January, Nair was named to the Silicon Bayou 100 as a top innovator in Louisiana. According to Silicon Bayou News, “The system that Dr. Nair helped develop for OMS offers a Stage 2 certified electronic health record built from the ground up for cardiology specialists. By maintaining a narrow focus on cardiology, the system is able to offer an elaborate, powerful, and user-intuitive solution.”
Nair has more than 20 years of experience in both interventional cardiology and computer science. Fail is board certified in internal medicine, cardiovascular disease, and interventional cardiology. Abben has a broad experience in interventional cardiology and cardiac electrophysiology, and is a lecturer, researcher, and published author in both areas. Chaisson has more than 35 years experience managing cardiovascular product lines and cardiology practices.
“The highlight of the OMS cardiovascular portfolio is the enormous potential to capture more than 5,000 discrete data elements per patient spanning across 15 diagnostic modules,” Nair said. “This single database allows for seamless access to this discrete data and diagnostic test results from within our comprehensive cardiovascular electronic health record.”
The diagnostic module includes: transthoracic echocardiogram, transesophageal echocardiogram, dobutamine stress – echocardiogram, renal arterial ultrasound, carotid arterial ultrasound, mesenteric arterial ultrasound, abdominal aortic ultrasound, lower extremity arterial ultrasound, lower extremity venous ultrasound, ankle brachial index, exercise treadmill test, exercise myocardial perfusion imaging, chemical myocardial perfusion imaging, cardiac CTA, and ambulatory EKG monitoring. Also, the clinical decision support feature within the EHR is able to scan the data elements, as well as support formulation and extraction of complex clinical decision support queries.
For example, a patient with heart failure, reduced ejection fraction, and high BNP (brain natriuretic peptide in blood) is observed in real time and the software suggests intervention options to the cardiologist during the visit.
“Programming is a passion. I’ve been programming since 1990,” Nair said of an effort that grew from his desire for seamless information within a large cardiology practice. He saw a lot of people trying to get data from charts and decided creating software to do it might be the best way. “We didn’t think about commercializing at the time, but we saw how it could uniquely make us efficient with quality care and minimize the risk in the often hectic environment of cardiology.”
Since Nair’s team came out with the 15 OMS diagnostic module in 2011, it has gained use in 16 clinics in South Louisiana. Requests are coming in for it and plans are to scale up marketing and sales in the next 12 to 18 months.
“We built the software ground up with cardiologists in mind,” Nair said of a major advantage to using his software. “We believe we’re able to do what we do by focusing solely on cardiologists. Our solution was designed to collect “discrete data” and display it into a user-friendly format that allows the physician to access patient information between affiliated hospitals and cardiology clinics. For example, if a patient had an echocardiogram one year ago at the hospital via OMS software and had another echocardiogram six months later at the clinic via OMS software, the patient would be linked. The test values would automatically be compared and a corresponding report with intelligent intra-modality and inter-modality comparisons between each structure within the two echocardiograms would be generated.
Physician reminders regarding these tests may be offered via clinical decision support rules set by the ambulatory cardiology. The physician would also be able to add key notes to the report for unique patient encounters or adjust report information as needed.
What Nair did realize was the software, if designed well, could cut by 30 percent lost time spent on getting stale paper reports versus accessing intelligent actionable electronic discrete data. The implications of this added efficiency meant the difference between spending up to 10 minutes with a patient instead of two minutes and still have more information about that person’s treatment, which is significant in today’s increasing industry pressures for high-patient volume.
“We find ourselves fighting the EHR to get desired data; intelligent software can enhance the efficiency for the cardiologists,” Nair said of providing a way to make records transfer seamless by developing software that can work with any third party software. “In our case, the data migrates to our software. The federal government is trying to standardize this communication, which means our OMS software should be able to communicate across all physician practices in the area and to systems outside the network.”
Nair said some legacy software (old technology) doesn’t communicate with the stage 2 software and this “creates roadblocks with EHRs. The new stage 2 format facilitates the seamless flow of information between clinics, hospitals, and vendors.
It was one of the major challenges that he encountered in developing the program. “I learned that it’s very difficult to make a software that looks and behaves very simple in the face of complexity,” he said. “We strive everyday to make the software user-friendly. The most difficult part is to make the software very simple with fewer clicks for the end user – what should only come out of the software is the data.”
Time is extremely critical in cardiology and Nair said their EHR is intended to capture large amounts of data across multiple practices. The initial impetus of making the software was not to treat the patient quickly, but rather for the system to analyze the discrete data compiled within the OMS Cardiovascular portfolio.
A cardiology practice is different in that cardiologists make diagnoses based on diagnostic tests, and the software collects findings. Nair said their software rounds up these findings by communicating and importing data from devices, such as the echocardiogram machine. The software doesn’t do the full report, but he pointed to its ability to round up the information and display the data in one place for the cardiologist to make a quality decision.
“A patient may have five sonograms in the past and it can offer trending information, offering a picture on how those heart functions are evolving over time,” Nair said. “This allows the cardiologist to make a more informed decision viewing current data, but also historical data. There is a chance the cardiologist may not have time to look at multiple studies on a patient – it enables cardiovascular intelligence.”
Nair emphasized the software is not intended to replace the physician, but it can facilitate faster, better quality decisions. It puts intelligence on the patient at fast access, compiled in a readable form, which is especially important for cardiologists, who are data intensive with multiple diagnostics. “This requires a software solution to clearly help communicate with these devices with graphic data,” he said.”It boils down to improving time efficiency, providing quality patient care, and generating consistent, structured reports.”
The software also decreases free text typing, dictation, and transcription by incorporating Nuance voice recognition.
According to Nair, before OMS, turnaround time for diagnostic reports being finalized within 48 hours occurred only 45 percent of the time, now they are finalized within 48 hours 95 percent of the time. This is a huge win for the patient getting test results in a timely manner and the physician meeting the target finalization criteria.
“As more medical data is generated by patients and processed by computers, much of medicine’s diagnostic and monitoring aspects will shift away from physicians,” he said. “The patient will remain in charge, turning to doctors chiefly for guidance and treatment.”