Epiphany Cardio Wants You to “Follow Your Heart” This February

This February, in observance of the American Heart Association’s “American Heart Month,” Epiphany Cardio wants to encourage you to “follow your heart.” We want you to personally join the fight against heart disease by maintaining an active awareness of cardiovascular health and following the path to a heart-healthy life. So, how can you “follow your heart?” Here are some tips:
 

Follow the Facts

Obtaining and maintaining awareness about heart disease helps keep you conscious of the importance of cardiovascular health. The facts below should get you thinking about just how serious the topic is.

• In America, heart disease, including stroke, is the number one cause of death for both men and women.
• One out of every three deaths in America is from heart disease and stroke. This comes out to about 2,200 deaths per day. 
• 71 million Americans have some form of heart disease.
   

Follow Your Risk

Understanding the magnitude of the issue is important, but alone it is not enough. Identifying which risks apply to you personally is a crucial step towards achieving optimal cardiovascular well-being. Check the following list. If any of the following applies to you, you are at increased risk for heart disease.

• You are a male 45 or older
• You are a female 55 or older
• You have a history of heart disease in your family
• You have high blood pressure OR high blood cholesterol
• You have diabetes
• You are overweight
• You are physically inactive
• You smoke
• You are constantly under stress
   

Follow-Up With Action

Understanding the scope of heart disease and knowing which risk factors pertain to you are two integral steps towards cardiovascular health, but they are useless if they don’t lead you to action. Taking appropriate action against any of the risk factors above can reduce your risk of heart disease or even reverse damage to the heart. Even in cases where the factors are beyond your control, like those concerning age, gender, and heredity, taking any of the following actions can help minimize your risk.

• Quit Smoking: The Surgeon General has called smoking "the leading preventable cause of disease and deaths in the United States." Quit now and start decreasing your risk of heart disease immediately.
• Maintain a Healthy Weight: Don’t just lose weight, keep it off and greatly reduce your risk of heart disease.
• Exercise on a Regular Basis: 20 to 60 minutes per day regularly, three to five times per week.
• Eat Healthy: Lean meats, low-fat dairy products, and foods that are low in cholesterol, added salts, fats or sugars.
• Treat Existing Health Conditions: If you have high blood pressure, high cholesterol, or diabetes, get regular check-ups and follow your doctor’s instructions. 
   

At Epiphany Cardio, it’s our business to help you “follow your heart” with our products and services. Please, this February, help us help you by starting down a life-long path to cardiovascular health by utilizing the tips above.  Also, feel free to help us participate in American Heart Month by passing these tips along to your loved ones.

What can you expect from Epiphany’s implementation process?

When dealing with many software and service vendors in the healthcare industry, it is natural to ask, “What can I expect from the Project Management Team?” The Epiphany implementation team strives to be customer-focused and to deliver a quality product to your facility. To meet this goal we have several ways to support you. A typical project with our implementation team and your resources usually takes 12 to 18 weeks. We assign a skilled Project Manager, technical/HL7 resources and a Clinical Training Specialist to each project. With these three resources, we are able to provide quality guidance throughout the process and post go-live.

We work closely with your project and clinical department leaders to properly identify the current workflow and desired future workflow. By conducting several calls and product web sessions we will guide you through the process. We also work closely with your interface resources, PACS administrators, and/or IT personnel to achieve project completion. One of the reasons you may have selected Epiphany is to enhance your facility’s clinical workflow for your technicians, physicians and administrators. We are committed to achieving these goals with every facility.

A typical project will include:

• Bi-weekly status calls with alternate weeks fortesting/configurationmodifications
• Device configurations
• HL7 recommendations
• Remote testing support
• Experienced Clinical Training Specialist assistance with workflow needs, remote and onsite training, and go-live needs
• Basecamp project plan access (Basecamp is a web-based project management application tool that allows Project Managers to view and manage implementation tasks, deadlines, and upcoming events associated with the project)
• Skilled project guidance for each timeline

Before you look at purchasing any system we encourage you to ask how the implementation will work. If you would like more information on Epiphany implementations please let your sales representative know or contact the implementation team directly at 804.744.8931.

 

Implementation of Cardio Server: Paper-Based versus Digital Migration

Whether your hospital or clinic has been managing digital diagnostic test results for years, or you are just now thinking of going digital with an ECG Management System, Epiphany has a process for implementing Cardio Server to suit your needs.

Paper-Based:

If your institution is currently storing diagnostic test results in a patient folder or scanning them directly into your EMR without an electronic signature, consider Epiphany’s PDF Naming Wizard.

This feature, which was a customer’s idea originally that we then implemented, offers a suite of workflow productivity tools associated with scanning in paper reports. With Epiphany’s Naming Wizard you can:

• Import and categorize PDF studies for a variety of different diagnostic test results including ECG data

• Electronically import and assign patient demographic information via ADT or an orders feed

• Assign studies to a physician or physician group

• Access studies from virtually anywhere using a standard web browser

• Compare new studies to previously captured patient studies including ECGs

• Enable physicians to view and add interpretations and electronically sign a report prior to sending the result to your EMR

• Reporting capabilities for quality assurance and process improvement

Epiphany works with you to ensure that this process is accurate and organized. If your hospital does not want to scan in old studies with the PDF Naming Wizard, your physicians can simply view the new digital study on Cardio Server and compare it to the previous, paper study.

Digital ECG Migration:

For hospitals with an existing ECG management system, we can digitally migrate your legacy ECG data into Cardio Server. Epiphany extracts ECGs from the source ECG management system, processes the data, then loads processed ECGs into Cardio Server making it available for visual comparison and Epiphany’s Intelligent Serial Comparison. 

ECG comparison is important because it helps show the reading physician how an ECG study has changed from the previous one. Most Epiphany customers that had already owned an ECG management system request a migration, since the ECG data is already digital.

For more information on implementation for a paper-based or digital migration of ECG data, leave a comment below and your question will be answered promptly. 

Epiphany Cardio’s Customer Advocacy Program (CAP)

Whether you are considering Epiphany or you are a current customer of ours, you may ask yourself, “What support can I expect to receive from Epiphany after my Cardio Server go-live?” Of course we have 24/7 technical support for the customers, but we also want to proactively reach out to you to make sure all needs are being met. Our goal is to make sure you are completely satisfied and to provide a consistent way for Epiphany to receive your feedback.

Epiphany launched the Customer Advocacy Program (CAP) to answer this very need. To better serve our customers we want to ensure they have access to a Clinical Specialist who can help answer workflow questions or general end user concerns. A common workflow question we hear is "I would like to set up my remote pediatric cardiologists in Cardio Server so I don't have to fax to them anymore. They dislike the poor quality of the faxed tracings. Can you help me with this?" Periodically throughout the year, your Clinical Specialist will call you to answer questions like this and ensure you have everything you need from Epiphany.  

Your Epiphany CAP resource will:

• Review your service history

• Inquire whether your system is functioning as desired

• Ask if you are experiencing any workflow problems we may address

• Introduce new product modules for the current system

• Introduce you to useful tools at epiphanycardio.com

• Schedule web-based refresher training or help with new employees

• Assist in running administrative reports

• Answer physician questions or concerns

• Address any enhancement requests 

Epiphany’s continued success is fueled by our commitment to exceptional customer service. CAP has allowed Epiphany to get feedback from our customers and be proactive for ongoing product improvement.

            

Pictured above are (from left) Pat White, Bryant Biek, and Vickie Carlson, Epiphany's CAP Representatives. 

 

Epiphany Cardio Continues to Grow

In the past few months, Epiphany Cardio has added some dynamic new members to our team. We’d like to introduce you to our new faces:

Bryant Biek: 

Bryant comes to Epiphany with a background in both the clinical and technical side of non-invasive cardiology testing. He graduated near the top of his class from the Paramedic program at St. John Mercy – St. Louis, he then worked for two years as a Cardiographic Technician at another hospital, performing ECGs, Holter scans, pacemaker checks and assisting physician with stress examinations. After earning his A+ and MSCE certification, Bryant worked in the construction, insurance, and retail industries doing desk side and system support before, as Bryant puts it, he started “the first job that justified all my student loans”. The past 5 years Bryant has worked for Cardiac Science supporting an ECG Data Management System doing, among other things, HL7, web integration, device connectivity and the training of IT and biomed personal, while continuing to work PRN an as an ECG Technician.

When asked about joining Epiphany, Bryant replied, “I am excited to be part of a company that listens and responds to customer inputs while continuing to improve and expand its product. I look forward to working with everyone and being a part of Epiphany’s present and future success.”

 

 

Brian Claxton:

Brian Claxton is our Regional Sales Specialist for the Western region. Based in Denver, Colorado, he has over 30 years of cardiology and healthcare IT sales with companies including Quinton/Cardiac Science and Philips Healthcare. He is excited to utilize his clinical and IT background to help customers improve efficiencies in treating patients and achieving improved healthcare standards. While not on the road, Brian enjoys climbing the highest peaks in Colorado and competing in bicycle races.

 

 

Felicia Cooper:

Meet our new software technician, Felicia Cooper. Before joining the Epiphany Team, she worked at Misys and Allscripts supporting EMR and Interface. She has over twenty years of Clinical Support experience. 

She was born on Labor Day, and is the youngest of 14 children (9 brothers and 4 sisters). She moved to North Carolina eight years ago from New York, but still has a New York accent. When asked how she feels about joining Epiphany, She says, “I look forward to getting my training wheels off and becoming a valuable asset to the team.”

 

Kathy Riley:

Kathy Riley is our Regional Sales Specialist for the Midwest region. She is based in Wisconsin and has sold Management Systems for Mortara Instrument, Marquette/GE and software for Philips Healthcare. She is also a former Respiratory Therapist. She’s anxious and excited to share with others the benefits of Epiphany’s Cardio Server solution for diagnostic test results. Kathy also has a Wisconsin accent.

 

 

Taylor Pike:

Taylor Pike is our new Regional Sales Specialist for the MidAtlantic region, and he’s based in Charlotte, NC. Before joining Epiphany, Taylor spent over six years in the Air Force, honorably discharged and recognized as a combat veteran. He came to us with over two years of experience as a manufacturer’s sales representative who sold Epiphany's product. When asked what he thinks about his new position here, Taylor says, “Epiphany is a company I love because of the folks involved. The leaders operate with excellence and integrity and putting the customer first. Those characteristics trickle down to the others and it's infectious.”

  

 

Greg Wagner: 

Greg Wagner has joined us as the Regional Sales Specialist for the Northeast Region. Greg has been working in medical sales for over three years throughout the Northeast. He represented and sold Epiphany’s product before joining us as well. Originally from Connecticut, he obtained degrees at the University of Colorado in marketing and finance and pursued skiing. When not working hard for Epiphany, Greg can be found surfing with friends or playing soccer around Boston, MA, where he currently resides. 

 

On behalf of the Epiphany Team, we'd like to welcome new team members. We look forward to a long and successful journey ahead.

 

 

Customer Resolves Workflow Challenge with Cardio Server on an iPhone from Church

Nicole Horve, Supervisor of Cardiovascular Services at St. John's Hospital in Springfield, Illinois recently relayed this success story to Epiphany Cardio.

While in church on a Sunday, Nicole received a call from the reading cardiologist stating that an ECG he had confirmed would not come out of the list. Logging into the hospital’s Cardio Server from her iPhone, Nicole found that the ECG had become un-linked from its order. She re-linked the ECG to its order, verified its promotion to the confirmed queue, and then called the cardiologist to let him know he could proceed with his interpretation and confirmation. She solved the problem and satisfied the physician’s request without having to leave church and go back to the hospital. All actions were performed in a matter of minutes.

Epiphany’s Cardio Server is a pure-web, browser-based application, meaning no special software is required to view ECGs or perform administrative functions. With proper security permissions from the Information Technology Department, physicians can use iPhones and other smart devices to visualize acute ECGs as they are notified of them. Beyond this important clinical use, having the power of the iPhone and Epiphany’s Cardio Server creates a facile way of performing system administration from any location that has cell service.

 

Cardio Server Changed Workflow for Physicians at Northeast Georgia Medical Center

Northeast Georgia Medical Center (NGMC) in Gainesville, Georgia, is a 557-bed hospital northeast of Atlanta. HealthGrades® rated NGMC number one in overall cardiac care for the entire state of Georgia, and in the top 5% in the nation, for the last six years in a row (2006 – 2011).
 

NGMC performs ~60,000 ECGs per year. Like many hospitals with that volume, it was not uncommon for ECGs to remain unconfirmed for extended periods of time as physicians read on paper in the Cardiology Department.

With the installation of Epiphany’s Cardio Server at NGMC, physicians are now able to view ECGs immediately after they are acquired with the previous ECG available on the same screen. They can view these studies in the same high quality just as if they had the original in their hands. The physicians can see these studies from any PC in the hospital or from their offices and homes; they can see them on their iPhones, their iPads, or their Droid phones. Cardio Server also tracks the number of studies they read for accurate reimbursement from the hospital.

In summary, installing Cardio Server at NGMC:

• Significantly reduced the amount of time it took to access an ECG from the time it was captured until it was viewable
  by a physician;

• Provides the previous ECG, when available, for comparative statement to be included in the interpretation;

• Allowed the organization to automatically bill for the procedure when the study was confirmed (i.e., no more missed charges);

• Prioritized viewing STAT ECGs immediately after they are performed from any PC, resulting in quick determination of severity of tracing;

• Gave the physicians the ability to read more studies in a shorter amount of time by not having to report to the ECG department and sift through a stack of papers; and

• Enabled multiple physicians to read at one time from various locations.

   

  
  
  
   

Cardio Server Shared by Multiple Hospitals within an Enterprise System

Epiphany offers broad flexibility to enterprise medical systems with multiple hospitals.

Multiple Hospitals sharing healthcare IT systems usually have diverse legacy devices and cannot afford the typical proprietary solutions that start with replacing working devices from various manufacturers. Epiphany is compatible with 100+ devices from over 40 vendors, supporting 15 diagnostic modalities.

Our customers have also shared with us that in multi-site systems each hospital needs to be able to define their own flexible workflow. Epiphany supports:  

• The ability to adjust Cardio Server to fit different workflow preferences for each site in a multi-hospital implementation. Examples include:
   
• Multi-hospital implementations often have more than one vendors’ cardiographs. Epiphany can migrate data from multiple legacy management systems and use that data to provide serial comparison reports on 12-lead ECGs from different vendors‘ cardiographs.
   
• HL7 messaging (order update, preliminary result, image update, final result, billing messages) can be sent to and received from multiple applications. For example, Cardio Server supports customized results for Epic and also for Cerner.
  
  
• It is common in multi-site installations that patients do not have a truly unique patient ID. Cardio Server can identify previous studies for a patient, even if those were performed with a different patient ID in another site. As an example, Cardio Server locates previous studies on name and date of birth.
   
• Cardio Server can be configured to not require order linkage for outpatient and clinics studies, but require orders for inpatient procedures.
   
• Some physicians confirm studies within the exercise stress application. Epiphany enables the stress studies coming from this hospital/clinic to be received as “confirmed” and pass onto the EMR while allowing other sites to confirm using Cardio Server.
   
• Multiple time zones are supported for enterprises that extend beyond a single time zone.

Epiphany values feedback from our customers. Listening and learning from our customers has allowed us to be proactive, adapt, and expand the functionality of our products to be flexible in supporting multi-site environments.  

For more information on Epiphany’s Cardio Server and/or its ability to deliver solutions for multi-sites:

Epiphany Streamlined Stress Workflow for a 220 Bed Hospital in Southern California

Epiphany installed its Cardio Server in a 220-bed hospital in Southern California in 2010. Like most hospitals that do not have an ECG management system, workflow for cardiography results before Epiphany was labor intensive. This essay describes how Epiphany streamlined stress workflow with dozens of customized forms for this hospital’s cardiologists.

The Hospital’s Stress Workflow Before Implementing Epiphany

The hospital went live with Epiphany’s Cardio Server in December, 2010. Cardio Server was configured to accept imports from resting ECG, stress, and Holter; upon physician confirmation, Cardio Server exports results to the hospital’s EMR.

Of these three modalities, stress was the biggest problem. Before Epiphany, stress workflow was laborious. Technicians printed stress studies and placed them in the individual cardiologists’ boxes in the reading room. Cardiologists had to make a trip to the reading room to read the stress studies and dictate a final report. Transcriptionists then created a preliminary report with the cardiologist’s dictation and placed the final report back in the cardiologist’s box for final review and signature. Delays, depending on reading schedules, were not uncommon.

The challenge Epiphany faced was to get the cardiologists to read on-line, thus eliminating the trip to the reading room, eliminating transcription, and eliminating the multiple paper copies of the stress studies. This challenge was harder given the cardiologists all had different ways they interpreted different types of stress testing.

Streamlined Stress Workflow After Implementing Epiphany

Epiphany’s Cardio Server is a pure-web, browser-based product. As such, cardiologists access it from any computer in the hospital, from their office computers, or their home computers; on-line reading eliminates multiple paper copies. Pure-web access also solved the problem of the cardiologists making daily visits to the reading room; pure-web access speeds the time between study completion and diagnostic test results posting to the EMR.

Epiphany solved the second problem, the variance in types of stress tests used by the individual cardiologists, by creating customized forms. Forms are fully formed paragraphs that duplicate what a transcriptionist normally types. By taking discrete data results out of Quinton Q-Stress, Epiphany automatically populates those results into the appropriate place on the form (e.g., maximum heart rate, maximum ST level, etc.). Transcription eliminated.

Finally, Epiphany created several forms customized to each cardiologist’s writing style. Multiple forms were built for each cardiologist and for each type of study.  Customized forms were created for routine exercise testing, stress echo, Cardiolite, Lexiscan, Dobutamine stress and Dobutamine echo. Epiphany threw in some forms for Holter for good measure. Now all that is required of the cardiologist is to select the appropriate form with a click, read the populated results, tab to any of the variable fields for pick-list or free-text entry, and confirm it. The study is digitally signed and posted to the EMR.

The best part is that all this comes standard with the purchase of Cardio Server! No extra budget for this custom work is required. We do it before we get on site, while we are on site, or after go-live. We do it to make your days shorter, not longer.

Cardio Server's Solution to Interface Challenges: Billing

HL7 Integration Developments – Technical Charges, Professional Charges, and Credits

Technical Charges and Credits

Flexible HL7 integration allows a technical charge for a procedure to be generated at the time of order closure. This corresponds to a promote action in Epiphany’s Cardio Server.

The technical charge code is flexible. It may be based on the diagnostic test result (e.g., ECG, Stress, Holter, PFT), the USID (order procedure code), or the site. It is most often a static value established by the modality.

The counterpart to a technical charge is a technical charge credit. We generate a technical charge credit when an order is re-opened. This corresponds to an unlink action in Cardio Server.

With technical charge and credit HL7 integration in Epiphany, there is no worry about manually billing or crediting patients for diagnostic test results.

Professional Charges or Credits

A second charge, the professional charge, may be generated at the time of the physician signature. This corresponds to a confirm action in Cardio Server. The professional charge is also flexible, and can be based on diagnostic test result, USID, site, signing physician, or a combination thereof.

Administrative users can maintain sign-user based professional charge codes, similar to maintaining doctor mnemonics or Provider IDs, in the Epiphany user administration tool.

The counterpart to a professional charge is a professional credit, which is functionality scheduled for a future release. This occurs when a study is “unconfirmed”.

Subscribe to our blog for regular discussions of complex interface and implementation challenges and their solutions.