By Dave Pearson
A family from Pennsylvania’s Plain People community, which consists primarily of Amish and Mennonite families, recently took their child to Cardiology Care for Children (CCC), a small yet regionally renowned practice in Lancaster. They’d been referred by the girl’s pediatrician, who was concerned about her irregular heart rate. At CCC, sonographer Rebekah Tomredle skillfully scanned the patient’s chest with a new diagnostic ultrasound system the center had acquired only a few months prior. Upon interpreting the echocardiogram, pediatric cardiologist Devyani Chowdhury, MD, noted that the child had a Sinus of Valsalva aneurysm, which would require a surgical intervention.
“This was a self-pay patient whose family didn’t have much in the way of resources,” recalls Chowdhury. Had the echo not been performed properly and with state-of-the-art equipment, she adds, “we would have missed that finding. And the patient would have most likely never had another echo” because of their financial constraints.
“We may have prevented a sudden death,” Chowdhury says, “in the second or third decade of that patient’s life.”
This is just one case that Chowdhury, CCC’s medical director, and Tomredle, its technical director, are quick to describe when asked to recall recent episodes of care in which highly advanced technology made it possible for them to save or improve a young person’s life.
Their memories are fresh for two reasons. For starters, all children with heart conditions are unforgettable to the healthcare professionals who care for them. Secondly, Chowdhury and Tomredle selected the technology after long and careful tryouts of multiple products on the echocardiography market.
What’s more, when they began using the system, they made CCC one of the first provider organizations in the U.S. to pair this particular premium ultrasound machine—Hitachi’s Lisendo 880 with 2D and 3D capabilities set up specifically for cardiovascular indications—with Hitachi’s new-by-acquisition PACS offering, the cloud-based VidiStar system.
That was last May. Eight months later, Chowdhury and Tomredle report they are delighted with the performance of Lisendo, VidiStar, the combined might of the two technologies together—and, maybe most of all, the people of Hitachi Healthcare Americas.
“Hitachi’s support teams for both Lisendo and VidiStar have done pretty much everything we’ve asked them to do,” says Tomredle. “And the company wants to make as high-quality a product as they can, too.”
“And the Hitachi leadership is honest,” adds Chowdhury. “It was a refreshing surprise.”
The topnotch care that children and their families receive at Cardiology Care for Children is, in many ways, a direct reflection of Chowdhury’s combination of vast experience and deep commitment to never compromise quality of care. She’s been practicing her specialty for several decades, including the last 11 years in Lancaster. She’s a steady researcher as well as a busy clinician. And she’s nationally known in pediatric cardiology circles for, among other contributions to the field, her ongoing work with the American College of Cardiology, Adult Congenital and Pediatric Cardiology Quality Section. She has been the leader in the field for development of quality metrics for ambulatory pediatric cardiology care.
As for the CCC, around 3,500 patients walk through its doors each year. Close to 2,000 of them receive cardiac ultrasounds, and some 200 to 500 of the resulting echocardiograms, or “echoes” for short, are incorporated into patient-centered clinical research studies to be lead-authored or co-authored by Chowdhury.
The county served by the center is home to around half a million people, including the Plain People population. This unique population pays for their own medical care (no health insurance), so access to affordable care is essential. At CCC these patients receive high quality care at an affordable cost, making it a true value-based experience for the patients.
“We are an independent practice that provides honest and transparent high quality patient centered care at a community level. Patients feel valued in our practice and are very confident that they will get a true, unbiased opinion.” Chowdhury says. “We would send a patient all the way to California if that’s what it takes to obtain the best surgical results for the child. We always try to connect the child’s heart with the best surgical hands. Every child is a part of our extended family.”
It was that guiding goal that prompted Chowdhury and Tomredle to go shopping for new echocardiography and PACS systems in early 2018. They decided second-to-none performance, ease of use and efficiency would all be prerequisites in both categories.
“Our studies are being looked at by tertiary care centers, and we don’t want to be labeled as a low-quality private practice that is doing horrible echoes that everybody has to do over,” Chowdhury says. “We want to be top of the line with quality. We are very sensitive to the time and money spent by our patients and feel obligated to deliver only the very best. Offering affordable care is no excuse for absence of quality.”
This uncompromising approach to quality and service led Chowdhury and Tomredle to narrow the field of ultrasound contenders until, finally, only one remained: Hitachi’s Lisendo 880. VidiStar was a natural simultaneous selection, since their old PACS only worked with its own vendor’s ultrasound machine.
Their top priorities for imaging and reporting were speed, versatility and a cloud-based solution that would let Chowdhury view images and reports while traveling, working from home or sitting at any computer workstation in the office. In VidiStar, they got all of that and more, Tomredle says.
“One thing I love about the VidiStar platform is that, when we have different types of studies sent to us—MRIs, CTs, cardiac cath images—we can load all of that into our cloud-based PACS and link it to the patient,” Tomredle adds. “And then everything Dr. Chowdhury needs is right there at her fingertips. We don’t have to run around to different computers, worrying about what plays well with PCs, what plays well with Macs and all of that.”
Prior to May 2018, Tomredle says, that kind of running around was a necessary headache. Today, Chowdhury volunteers, that’s all in the past.
Fast-forward to the winter of 2018-19. Having gained hands-on experience with the Lisendo 880 and VidiStar PACS for the better part of a year—for both purely clinical and research-related work—Chowdhury and Tomredle are confident offering several observations on each technology.
Chowdhury and Tomredle in their own words on Lisendo 880:
Chowdhury and Tomredle in their own words on Hitachi’s VidiStar PACS and reporting system:
Which brings the discussion back to recent cases with good outcomes made possible by CCC’s investment in technology. Chowdhury and Tomredle recall a patient whose pulmonary arteries were difficult to visualize due to the surgeries she’d had.
“Our previous machine could never get good color Doppler images to let Dr. Chowdhury really assess them well,” Tomredle says. “We would have to send certain patients for additional testing or advanced imaging (MRI). With the new machine, we have excellent color Dopplers, so this patient didn’t need to go for additional testing to assess the pulmonary arteries. That saved the patient and her family hassles and higher financial burden as well.”
To this Chowdhury adds: “I really think Hitachi is in sync with how clinicians and researchers use technologies today. Usually medicine lags behind other industries. I am very happy to see that all these capabilities are right there for us and that we have been able to make them a part of our practice.”