Healthcare IT in CardiologyDiagnosing even the most complicated cardiovascular problems with minimal staff

Healthcare IT in Cardiology

August 27, 2013 | With 644 beds and upwards of 1,500 outpatients every day, Saiseikai Utsunomiya is the largest hospital in Japan’s Tochigi Prefecture. Even with limited resources and under time-pressure, the hospital still needs to provide every patient with consistently high-quality healthcare. With the combination of syngo.plaza and syngo.via, Siemens offers the means of diagnosing even the most complicated cardiovascular problems – with minimal staff.

Text: Charles T. Whipple
Photos: Hans Sautter

For Japanese hospitals like Saiseikai Utsunomiya, it is a reality that emergency diagnoses at night or on national holidays must be carried out using what can only be called insufficient manpower. In such situations, an absence of specialist technicians and doctors in radiology could mean a drop in diagnosis or image quality at such times.

High diagnostic quality in low manpower situations
“We were well aware of that problem,” said Masanori Honda, MD, Vice President of Saiseikai Utsunomiya Hospital and a diagnostic radiologist and interventionalist in his own right. “And our choice for providing the quality of images and diagnostics in low manpower situations were the syngo.via and syngo.plaza imaging IT solutions from Siemens¹.”
syngo.plaza is Siemens Picture and Archiving Communications System (PACS) that supports high-throughput reading. Its tight integration to the syngo.via 3D routine and advanced reading software helps accelerate workflows across all modalities.
Cardiovascular emergencies demand immediate diagnosis, and any delay in treatment may result in the death of the patient. Dr. Honda recalled the example of one of his former patients: “The man arrived in the emergency room being unconscious. At one point, his heart stopped beating, but we were able to resuscitate him.”

An image in time can save lives
According to Dr. Honda, the patient was then transferred immediately to the radiology department, where a multislice computed tomography exam was performed at 8:20 p.m. Before the cardiovascular specialist had even sat down at the workstation, a color-coded 3D image of the patient’s cardiovascular system was forming on the screen. It showed a ruptured aneurysm of the aorta. The doctor ordered an endovascular repair. Within minutes, in an interventional procedure the bleeding of the aorta was stopped and the stent graft procedure was completed by 9:30 p.m. The patient survived.

Fast reading of routine and advanced cases
Dr. Honda grinned: “That patient walked out of the hospital five days after the endovascular repair. Of course, he was unconscious during the emergency and did not understand what had been done for him. I’m not sure he was as thankful as he might have been. But then, how could he know?” As Dr. Honda explained, major hospitals want to remain fully operational 24 hours a day, 365 days a year, but this is not always easy. Even Saiseikai Utsunomiya has had problems with technician expertise keeping up with advances in medical devices. “That’s where Siemens was a great help,” Dr. Honda said. “They were able to hook up every modality to syngo.via and syngo.plaza. That meant we could work with a single platform and didn’t have to learn the peculiarities of every modality in the system.” Dr. Honda went on to explain, “We were looking for a system that would bring data from various modalities together – resulting in efficient reading.” Thanks to the tight integration, the combination of syngo.plaza and syngo.via enables fast reading of both routine and advanced cases.

Help in emergency care
Before the introduction of syngo.via at Saiseikai Utsunomiya, doctors had to peer at black, white and gray images taken directly from whichever modality was used. From those, they built 3D images of the patients’ cardiovascular system in their minds – searching for the pathology and making a diagnosis. “Now, 3D images are a great help in our emergency care,” said Dr. Honda. “[The system] even measures the target vessel, so there’s no need for calipers. The likelihood of measurement errors drops to virtually nil.”

24 hours a day, 365 days a year
Since Saiseikai Utsunomiya systematized and digitized its hospital systems, there was also a leap forward in the efficiency of its record-keeping: “We had no intention of laying off any of our people for the sake of this project,” said Dr. Honda. “The objective of installing syngo.via and syngo.plaza was to give our patients the best possible medical diagnosis and treatment. We felt that digitizing and getting rid of paperwork was essential to this.” Thanks to Siemens’ syngo.via and syngo.plaza, Saiseikai Utsunomiya is not only the largest hospital in its prefecture, it also provides consistently excellent hospital care 24 hours a day, 365 days a year.

Charles T. Whipple is an international award-winning author and journalist based in Japan. His articles have appeared in magazines and newspapers such as Time, Newsweek, the Chicago Tribune, and the International Herald Tribune. He has lived in Japan since 1977 and is fluent in Japanese.