Royal Berkshire NHS Foundation Trust has extended its use of McKesson Cardiology™ to support a new, physiologist-led echocardiogram Valve Clinic. The new clinic will minimise patient visits, cut waiting lists and improve access to consultants.
The cardiology department at Royal Berkshire Hospital conducts nearly 10,000 echocardiograms a year, and the process typically includes a consultant appointment where valve disease is present. After a cardiologist-led audit in 2015, the Trust determined that many of its patients with mild to moderate valve disease were exceeding the number of consultant examinations as outlined by the current guidelines. Consultants will now refer suitable patients to the Valve Clinic for future echocardiograms and follow-up with a physiologist after their initial visit.
McKesson’s Cardiovascular Imaging and Information Solution (CVIS) stores, reports and shares echocardiogram imaging — and the new specific Valve Clinic template builds on the standard functionality of the existing cardiology solution. The template also supports specific reporting of heart valve abnormality and surveillance and enables faster, improved referral decision making by the physiologists.
“McKesson CVIS prompts the physiologist to ask specific questions related to cardiac valve disease,” said Sandra Wheeler, Deputy Chief Physiologist Royal Berkshire NHS Foundation Trust. “This new service provides a check list of information — from medication to symptoms such as chest pain, palpitations and dizziness and even the most recent dental check. It’s invaluable because it makes it very easy to compare information to the patient’s last review.”
The Valve Clinic currently serves patients with mild or moderate valve disease – including aortic and mitral stenosis or regurgitation, patients with replacement heart valves and those with aortic root dilatation. These patients are typically on a 12 or 36 month review process. The clinic is currently open two days a week and the Trust expects to expand it to include several physiologists to provide services within the Cardiac unit and outreach clinics.
Each hour-long appointment includes height and weight and blood pressure measurement and then the British Society of Echocardiography (BSE) recommended study for valves, which is supported by the McKesson CVIS workflow. In addition to the echocardiogram, the clinic provides physiologists with an extra 20 minutes per patient visit to discuss symptoms with patients and complete detailed reports. All information is recorded on the echocardiogram report, which is held within McKesson CVIS. This provides consultants and clinicians with consolidated patient information such as ECGs, interventional procedures, Holter monitoring and correspondence — and enables a fast audit process which can be used for continuous review of patient outcomes.
“The Valve Clinic allows patients with mild and moderate valve disease to attend for an echocardiogram without seeing a cardiologist and refers patients on when required,” said Catherine Townsend Echo Lead. “By aligning patient visits with their clinical needs, the Valve Clinic reduces wait lists to help ensure that consultants appointments are more quickly available for patients with more serious valve disease.”