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performance in
congenital heart
surgery:
One medical team’s effort
to Achieve Information
Resonance
Redmond P. Burke MD
Chief, Division of Cardiovascular Surgery
The Congenital Heart Institute
IBM, Boca Raton, USA
2007
As physicians, we were painfully aware that we were not on the cutting edge.
We can instantly search 6 billion web pages, and find anything on earth…
….except your medical record.
Disclaimers
We repair most
of these babies
in the first week
of life, when
their hearts are
smaller than
your thumb.
The Congenital Heart Institute at Miami
Children’s Hospital and Arnold Palmer
Hospital
Handwritten Notes
Teleconferencing
E-mail
Digital Images
Reference Materials
Databases
Patient Monitors
Angiography and
Echocardiography
Studies
MRI
We had a very large, and growing, team
We needed to stay connected with geographically remote patients and
team members
Cardiac team members travel frequently
Patients are referred to high volume centers from remote locations: Blue dots
represent patients.
We needed access to critical data minute by minute at the point of care,
and year by year over our patient’s lifetimes
https://irounds.orhs.org https://irounds.mch.com
Despite this unprecedented access to
information, we were still not exploiting the full
potential of our system.
We were able to capture clinical information
automatically
We were able to remotely access data on demand in
the most complex situations
But we were still making up answers to important
questions…
When a family asked: “What are your results for this
operation?” the response was something like:
http://www.pediatricheartsurgery.com
…the technology enables us to base daily clinical decisions on
actual data.
A recent conference scenario -
A newborn baby presented with a complex defect, and one of the cardiologists
asked if we should do the traditional open surgery, or try a new interventional
procedure…
We used our Web based research tool to retrieve the data on every one of our
patients who had undergone these procedures in the previous 4 years, and reviewed
our actual experience
https://irounds.mch.com
If you told this swimmer his practice times a year after each practice, could he improve?
120
GDT
*
100
Mortality Number
80
60
40
20
0
0 500 1000 1500 2000 2500 3000 3500
Case Number
www.pediatricheartsurgery.com
Advantages of Real-time Performance
Measurement and Reporting
160 0 50 100 150 200 250 300 350 400 450 500
140
Patient Photos
120
100
Operative Images
80
60
History and Physical
40 Report
20