Measuring hTEE's Economic Impact

Author: Michael Burns, Director of Customer Development
Facility: ImaCor Inc. Garden City, NY
Summary: As hospital executives evaluate new technology in this ever challenging healthcare economic environment, they are often asked how they will measure the value of the investment in both qualitative and quantitative ways. It is no longer enough that a device or service provides clinical value. In this economy that is already assumed. However, even after making a decision to move forward with technology, hospital administrators are commonly asking themselves:
• How will I incorporate a new technology into my workflow?
• How will it impact my physicians, my staff and my patients?
• What is the economic impact?
• How will I measure it?

Scott Silvestry MD: Interview on Sophisticated Hemodynamic Management

Facility: Barnes-Jewish Hospital, St. Louis, MO, USA
Summary: In your 2-year experience in treating VAD patients with hTEE, where have you seen the value in hTEE’s Advanced Hemodynamic Management approach?

One of the ways we add value with hTEE is not just for the difficult RV but the difficult RV with pulmonary hypertension. If while assessing pulmonary hypertension you image the RV, if the RV is doing well, it helps gauge how aggressive to be in treating the pulmonary hypertension in terms of inhaled agents like Flolan or nitric. There is a significant cost associated with nitric specifically, and prolonged intubation with Flolan, as well. We are trying to use strategies to minimize RV damage, RV strain, and intubation time.

ImaCor Offers New Workflow Release

Facility: ImaCor Inc. Garden City, NY
Summary: We are pleased to announce the release of new software upgrades resulting in improved user experience and workflow on both our Zura™ and Zura EVO™ systems. The Zura 2.1.6 software now offers hTEE reports, essentially a record keeping checklist for physicians that enables tracking of pre- and post-assessments in real time, as well as more rapid image connection. The Zura EVO 2.2.2 software significantly adds to improved ICU workflow, an uninterruptable power supply capability for system transfer between ICU beds.

It’s the RV – No Surprise

Author: Harold M. Hastings, PhD, Co-Founder and Chief Technology Officer
Facility: ImaCor Inc. Garden City, NY
Summary: In the latest of three 2013 articles on hTEE in high-impact journals, Maltais and the Vanderbilt team found right ventricular dysfunction “diagnosed by episodic TEE monitoring” in 33% of “21 unstable cardiac surgery patients with postoperative instability” Was I surprised? Should you be surprised? What does this mean?

TJU hTEE-Guided ECMO Weaning Protocol Presented at ASAIO, Chicago, June 13, 2013.

Author: Harold M. Hastings, PhD, Co-Founder and Chief Technology Officer
Facility: ImaCor Inc. Garden City, NY
Summary: The TJU study found that "the positive predictive value for ventricular recovery by hTEE was 100% using the standardized ECMO weaning protocol (95% confidence interval 73 - 100%)" and concluded that their "hTEE-guided ECMO weaning protocol accurately predicted the ability to successfully wean ECMO." Weaning ECMO presents a unique challenge as blood flows shift dramatically and the heart is called upon to provide full cardiac output previously supported by ECMO.

Major study by leading physicians at Bern University Hospital answers three key questions about hTEE

Author: Harold M. Hastings, PhD, Co-Founder and Chief Technology Officer
Facility: ImaCor Inc. Garden City, NY
Summary: I am really excited by a recent study by Drs. Cioccari, Baur, Berger, Wiegand, Takala and Merz e-published in the high-impact journal Critical Care June 20: this study by leading physician users at Bern University Hospital answers three important "frequently asked questions" about training, utility, and accuracy.

Report from the TJU hTEE CME Course

Author: Harold M. Hastings, PhD, Co-Founder and CTO Jeff Normand, RDCS, Director of Marketing
Facility: ImaCor Inc. Garden City, NY
Summary: Leading surgeons and intensivists from cardiac surgery, mechanical circulatory support, trauma and neurology shared a common focus on functional hemodynamics as visualized by hTEE. All specialties shared a common mission - optimizing hemodynamics – and all specialties used the three-view hTEE exam to obtain mission-critical insights into the patient’s functional hemodynamics to diagnose problems and manage therapies.

Henry Ford Hospital hTEE Use

Author: Sharon Matkosky, ACNP-BC
Facility: Henry Ford Hospital, Detroit MI
Summary: Since 2009, the CTS Advanced Practice Team comprised of Acute Care Nurse Practitioners (NPs) and Physician Assistants (PAs) at Henry Ford Hospital (Detroit, MI) has been responsible for providing 24/7 coverage in the Cardiovascular Intensive Care Unit (CVICU). Working with senior staff surgical and intensive care physicians, they are responsible for initial assessment, initiation of treatment protocols, and continual assessment of critically ill patients during the pre- and post-op period following advanced cardiac and aortic vascular surgery. In addition, this team provides advanced clinical coverage for patients on the cardiovascular general practice unit during the evening and night shifts. They are responsible for assessing the clinical situation, ordering adjustments to medication and therapeutic treatment plans, providing rapid, emergent intervention and initiation of resuscitation protocols, as well as performance of multiple types of complex invasive procedures in collaboration with the attending surgeons. The provision of consistent levels of advanced clinical support has contributed to the decrease in episodes of “failure-to-rescue”, improved continuity of care, improved patient/physician satisfaction and a substantial improvement in the adherence to quality core initiatives.

The Economic Opportunity in Critical Care

Author: Rich Lanzillotto, Director of Regulatory Affairs and Quality Assurance
Facility: ImaCor Inc. Garden City, NY
Summary: Healthcare enterprises find their feet held to the fire due to increasing emphasis on doing more with less. More, meaning better clinical outcomes, and less, signifying the available resources that can be committed to the clinical tasks at hand. The enterprises are feeling pressure from Insurance payers, Congress and taxpayers, all of which increasingly scrutinize the effectiveness and value of healthcare providers. The providers are responding in kind. Process improvement initiatives like Six Sigma are growing in popularity. These are designed to reduce the variation and uncertainty in patient care and hence reduce cost. Accountable Care organizations are being formed not only to deliver quality healthcare but also to be incentive based profitmaking business structures.

LEARNING hTEE: GETTING STARTED, GETTING BETTER, GETTING GOOD, GETTING VERY GOOD

Author: Harold M. Hastings, PhD, Co-Founder
Facility: ImaCor Inc. Garden City, NY
Summary: The striking recent growth in adoptions, significant cases, publications, and podium presentations by leading users at major international meetings has been very exciting for all of us at ImaCor and our leading physician users. Therefore, this seems to be a good time to review the process of learning hTEE.