Updates in Cardiovascular Diagnostics

Interview by Jodie Elrod
Interview by Jodie Elrod

Tell us about ScottCare Cardiovascular Solutions and the services you provide. 

Gregory: The business was started in 1989 and specifically focused on the cardiac rehab telemetry market. Our VersaCare product is a computer-based system to monitor a patient’s ECG and track the results for those patients going through post-cardiac surgery rehabilitation. 

Snehraj: As the leader in cardiac rehab we wanted to venture into additional areas of cardiology, namely treatment and diagnostics, so we purchased a company called Nicore, which added ECP treatment to our portfolio. We later acquired Rozinn Electronics that provided us the platform to create and market CardioView Dx Suite

Gregory: The CardioView Dx Suite is our product portfolio that includes Holter, Event, Ambulatory Blood Pressure and Mobile Cardiac Telemetry monitoring, as well as our OneView CRM software module. The combination of devices and software components allows physicians to review data, e-sign reports and interface directly into the EHR. 

Tell us about OneView CRM and its capabilities. 

Gregory: OneView is unique because it’s focused on providing a device-neutral platform for the capture, display and reporting of both remote and in-clinic CIED device interrogations. This means that regardless of the device manufacturer (Boston Scientific, St. Jude Medical, BIOTRONIK, Medtronic, Sorin, etc.), OneView retrieves the data from their proprietary web portals and provides a central location for users to easily complete their reporting and data analysis within a common workflow. These reports and discrete data elements are then integrated directly with the provider’s EHR. 

When was the OneView system launched?

Gregory: The product was launched in Q1 of 2011 and was quickly accepted in the marketplace. At this year’s Heart Rhythm Society conference in Denver, we launched OneView 4.0, which incorporates major workflow enhancements into the previous version of OneView. We were very excited to see how well the show attendees responded to it, and it immediately validated the upgrades made to the product.

What are some key benefits of OneView?

Snehraj: One of OneView’s most notable benefits is a simple but crucial one: to create an easy to use, uniform workflow for all vendor data. Therefore, whether your data originates from Medtronic, BIOTRONIK, Boston Scientific, St. Jude Medical or Sorin, OneView accumulates it and makes the information easily accessible to the user. Once the data is received, the next step in the workflow is to interpret the data; this is handled by the allied professional, physician or electrophysiologist. The interpretation then goes into final reporting where OneView provides standardized templates, as well as customizable reporting capabilities enabling each individual clinic to define their own interpretation sheet within the software. We also provide robust data mining capabilities so clients can perform research-related queries or easily identify device and lead recalls. So that’s the front end: the tools are easy to use; manage all data uniformly; provide a consistent workflow; enable a scalable, customizable reporting mechanism; and provide multiple research functionalities. On the back end we also provide a tool that connects OneView to the EHR so all of OneView’s data and reports can be seamlessly transferred. In short, the benefit of OneView is a user-friendly, vendor-neutral, end-to-end solution from the device implantation all the way to a user’s EHR. 

Gregory: As we’re talking about some of the key benefits of OneView, one of the other key features of the product is that it is web-based versus workstation-based. This in turn gives the clinician the flexibility to access, manipulate and report in OneView from any location as well as remotely. This single platform and common workflow simplifies the steps that research-focused physicians follow when conducting queries and aids in the management of device or lead recalls.

How does OneView specifically benefit CRM companies, and how does ScottCare work with these companies? How are you able to receive implant, remote and in-clinic device data from all of the device manufacturers?

Gregory: Until OneView was released, there really was only one solution available on the market. Additionally, the need for EHR integration has created an even higher demand for OneView. The product is enjoying increased acceptance from the CRM manufacturers because they value its’ vendor neutrality and appreciate how OneView’s common workflow benefits their customers. Our engineering team works directly with each CRM vendor to make certain we receive regular updates on changes in the devices or to their programmers. It’s obviously extremely important for us as a device-neutral software manufacturer to make sure our product continues to meet the demands and individual requirements for each of these CRM manufacturers. That is a big change in this space, and it’s what I believe is driving the acceptance of this product.  

Tell us about your Ambucor service division, and the services provided by Ambucor. What are some of the main customer benefits of Ambucor?

Gregory: Ambucor is a virtual workforce made up of certified technicians who function as a 24/7/365 extension of the provider’s practice for the administration of ambulatory diagnostics and remote CIED monitoring services. The service operates under the supervision of the physician and is required to follow their policies and procedures. A key benefit of Ambucor is that it allows the providers to offer services that would typically require the investment of additional full-time staff. Today, practices or hospitals typically use services called IDTFs (independent diagnostic and testing facilities) to provide this type of service, but Ambucor makes it possible for physicians to incorporate these services directly into the practice. It provides the practice additional control, transparency and oversight over the way the tests are being administered which can lead to improved clinical outcomes and increased patient satisfaction. 

How does the physician or facility interact with Ambucor employees? How are reports delivered to the physicians?

Snehraj: The physician has direct access to Ambucor employees because they virtually work for the group or practice. The only difference is that the Ambucor employees are not physically present within the practice. The practice has complete control of the patient data that is collected. 

Gregory: One addition: outside of the ambulatory diagnostic testing done via Ambucor, providers can also use Ambucor with the OneView platform to manage their remote CIED patients; this is currently our fastest growing service line at Ambucor. 

What new features can we expect to see with the launch of OneView CRM 4.0? When will it be available?

Snehraj: OneView 4.0 is now available under a limited distribution release, with full commercial release expected in June. In terms of new features, we have taken client feedback and incorporated many enhancements to our workflow. One of the most significant workflow stumbling blocks for device clinics has been related to the uploading of data from the programmers following in-clinic device interrogations. With OneView 4.0, we created ClinicSync to be the universal tool that gathers this data in a very methodical manner. It’s easy for anyone, even if you’re trying it for the first time, to quickly import the programmer data into the system. We’ve also incorporated smart reporting capabilities, that provide different templates for all types of devices (e.g., pacemaker devices, ICDs). This mechanism will automatically pull the appropriate template based on the chosen device. Finally, we’ve improved the bidirectional scheduling capabilities between OneView and the EHR. These are just some of the improvements in the OneView 4.0 release. 

What other future improvements do you see with the OneView CRM system as well as the implantable cardiac device industry?

Gregory: It’s all based on the feedback we receive from our customers. Our main priority is creating a highly usable product for the end user — their efforts should be focused on patient care, not software manipulation. Our engineers work diligently to ensure that the workflow within the system is streamlined, user friendly, and requires minimal clicks to accomplish specific tasks. ScottCare is highly experienced in providing data management solutions, whether it’s software focused on CIED devices (OneView), comprehensive ambulatory diagnostic monitoring (CardioView Dx), or the cardiac rehab market (VersaCare). Plus, the demand to get all this information into the EHR is huge, which is why all of ScottCare’s products have interface capabilities to accomplish it. You’ll continue to see advancements in the data management and interface solutions we offer our customers. ScottCare’s integration capabilities continue to drive interest and collaboration between our engineering team and each of the CRM manufacturers, with the objective of ensuring our products meet the expectations of our mutual client base. We’ve found these opportunities to engage closely with the CRM companies to be very beneficial, and I think that’s where you’ll see this company continue to focus its efforts. Such interaction allows ScottCare to not only advance OneView, but to engage in technology initiatives that will ultimately benefit the providers with rich content and effective patient care tools. 

Is there anything else you’d like to add? 

Snehraj: We will certainly continue to work collaboratively with the CRM companies and ensure that OneView stays in front of new device and programmer releases.

Client Experience: Interview with New Mexico Heart Institute

Here we speak with Cory Ott, RN, Electrophysiology Department Nurse Leader at New Mexico Heart Institute in Albuquerque, New Mexico. 

Tell me about your physicians and clinic. How many physicians are in your practice? How many patients do you currently follow in your device clinic?

In our main office we have 14 physicians — 4 of which are EPs — and we also have 9 mid levels. We have another office in Santa Fe and one in Roswell, but we’re operating OneView mainly out of the main office. We have about 4,500 active patients.

What device vendors do you currently manage? What type of implantable cardiac devices are you currently managing?

For our practice, our patient population is about 50% with St. Jude Medical devices, about 30% with Medtronic, 15% with Boston Scientific, and 5% with the other manufacturers. We manage everything, including implantable pacemakers, defibrillators, and implantable loop recorders.

Prior to using OneView CRM, how were you managing your device patients?

We were using Paceart for our main database, and we also tracked our patients through the website of each individual manufacturer.

When did you implement the OneView system? What were the primary reasons you chose OneView CRM over other options in the industry?

We implemented OneView in August 2012. We were looking for a system that was more equal to all manufacturers. Paceart works well with Medtronic, but since we have such a heavy St. Jude Medical population, we were looking for something that we could get the same information passed over, no matter who the manufacturer of the device was. We also wanted to own our software and all of our patient data versus paying for an annual contract.

How has OneView CRM helped your device clinic?

We were able to go completely paperless. Now, as soon as we enter the information into OneView, we electronically pass it through to our Allscripts EHR. Therefore, we don’t have the constant paper printing, and we’re able to keep better track of the reports. Sometimes in between printing and sending it to the doctor, waiting for them to sign it, and then getting it scanned into medical records or into the chart manually, we would just lose the paper copy. We definitely have improved the workflow process. 

How many patients can you manage with your OneView CRM system?

We manage all of our device patients through OneView. We have the database available on four computers at any given time, and our staff have access to all patients while in the system.

How has OneView CRM helped you fulfill Medicare’s “meaningful use” criteria by sending your device patient data and reports into your EMR?

Having immediate access to the records within our EMR is great, so that anyone who is in the practice can view them. I believe this is a better way compared to the weeklong delay that we had before, due to waiting for the paper copies and getting them signed and scanned.

Are you able to customize your device patient’s reports with OneView CRM?

Yes. We had a few limitations that we worked through with them, but the final product is a report that we designed with the input of all of our physicians. We tried to work on a lot of the stuff ahead of time so that it would be ready by our go-live date. We worked with the technicians at ScottCare as well as our IT department, and made a lot of changes in the first few months to actually get it how we wanted it. We thought we had it looking nice once it was live, but found it still needed to be tweaked a bit later on. 

How has OneView CRM’s web-based platform helped you access your patient files?

Mainly, our physicians can review the patient files from home — all of the doctors can look at OneView from their laptops and desktops.

Do you also use ScottCare’s Ambucor virtual labor service to support your ambulatory diagnostic monitoring and CIED remote device follow-up? What convinced you to deploy your ambulatory diagnostic monitoring and CIED remote device follow-up with Ambucor?

We wanted to use Ambucor because they’re a 24/7 service and are able to take the appropriate actions should something come up that would meet emergent criteria on their remote check. We have a large volume of device patients, specifically remote patients — we have about 2,000 — and we’re an outpatient clinic so we work 8:00-5:00. However, the majority of the manufacturers do their remote interrogations at 2:00 or 3:00 AM, so if something urgent were to show up, we wouldn’t actually know about it until the next morning at around 8:00 AM. 

What impact has ScottCare’s Ambucor virtual labor service had on your device clinic? 

We have a better compliance with our patients that we follow remotely, so this translates into patients receiving better care, because they are getting monitored on a more regular basis — even in between their 91-day scheduled remote checks, patients are still getting followed up by Ambucor with their daily check through the manufacturers. This also means we are able to generate more revenue since we are getting in our four remote checks per year. In addition, Ambucor helps do all of our scheduling for us as far as the remote patients, changing schedules as needed if a patient misses an appointment or checks early or gets a device changeout. They’re very helpful.