Exciting surgical, diagnostic & EHR tools

Robotically aided surgery of the brain and spine, diagnostic tests and an EHR for the heart round out this issue’s technology update.

By David Geer | Fall 2014 | Tech Notes

 

With the global robotic surgery market forecasted to grow 11.65 percent between 2013 and 2018, and cardiovascular diseases still the leading killers globally, consider the following technologies for your robotic surgery or cardiovascular diagnostics tool belts.

Mazor Robotics Renaissance Guidance System

Learn more at MazorRobotics.com.

Mazor Logo

The Renaissance Guidance System is Mazor Robotics’ next-generation mechanical guidance system for spine and brain surgery. Renaissance is an FDA-cleared mechanical guidance surgical system. The system offers 3D pre-operative planning for each patient’s specific anatomy and guides the surgeon intraoperatively for precise execution of that plan. Preplanning is advantageous as the system identifies challenging anatomy so the surgeon can make adjustments in implant size and location prior to the operation. This increases operating efficiencies by minimizing unforeseen anatomical issues. Neil Badlani, M.D., an orthopedic surgeon with the Orthopedic Sports Clinic in Houston, trained in spine surgery was looking to incorporate innovative technology and techniques into his practice to benefit his patients when he discovered the Renaissance Guidance System. “In order to place spinal instrumentation through smaller incisions with less muscle dissection and less radiation to myself and the patient, I have been interested in various types of intraoperative navigation. Renaissance is by far the best I have seen,” he says.

Badlani uses the Renaissance System in any surgery requiring posterior lumbar spinal instrumentation for spinal deformity, trauma, instability or severe disc degeneration. He also uses it in complex open spinal deformity cases to aid screw placement with difficult anatomy or for minimally invasive cases to percutaneously place screws through tiny incisions with minimal intraoperative radiation.

The Guidance Unit

The Guidance Unit—roughly the size of a Red Bull can—guides the surgeon’s tools within 1.5mm of accuracy.

“This technology allows me to place screws in the spine with extreme precision, safety and efficiency through smaller windows. This leads to more accurate surgery with less blood loss and quicker recovery,” Badlani says.

His favorite Renaissance System feature includes the preoperative planning capability. “I create a complete surgical plan before entering the operating room. During surgery, the system is quick, efficient, accurate and reliable,” he says. The Renaissance System also delivers cutting-edge technology while remaining very user-friendly, according to Badlani.

CardioDx Corus CAD

Learn more at cardiodx.com or email service@cardiodx.com.

CardioDx

CardioDx Corus CAD is a commercially available gene expression test that provides a current-state assessment of obstructive coronary artery disease (CAD) in non-diabetic patients presenting with typical and atypical symptoms. The test diagnoses obstructive CAD, taking the biological differences between men and women into account. This point is critical, as more than half of women with CAD present with ambiguous symptoms such as shortness of breath, fatigue and abdominal pain, making diagnosis difficult.

According to a CardioDx spokesperson, the patient’s cardiologist or primary care physician can both implement the simple, accurate Corus CAD blood test and order test results the day of the patient’s visit, receiving the labs within two to three days. The test results provide the physician with a score signifying the likelihood that the patient has obstructive CAD.

Courus CAD

Courus CAD provides current-state assessments of obstructive coronary artery disease (CAD).

Lee E. Herman, M.D., is an internist and founder of Johns Creek Primary Care in Suwanee, Georgia, and a user of CardioDx Corus CAD. Herman heads the private practice in internal medicine with a focus on preventive medicine and a special interest in preventive cardiology. When he found the Corus CAD test, he was looking for a non-invasive way to rule out CAD in the 90 percent of visiting patients whose chest pain and symptoms are actually due to non-cardiac causes such as heartburn, anxiety or musculoskeletal issues. The right tool would help him avoid exposing patients who most likely do not have CAD to unnecessary radiation risks and the procedural complications that are associated with traditional cardiac tests, he says.

“I use Corus CAD on my non-diabetic patients who present with non-acute typical or atypical symptoms of obstructive coronary artery disease. It is not indicated for patients with unstable angina, history of MI, diabetes, chronic and acute inflammatory illnesses, or previous revascularization procedures,” Herman says. According to Herman, in five years of his use of Corus CAD, the gene expression test has helped hundreds of his patients avoid unnecessary non-invasive imaging tests with radiation exposure.

Herman’s favorite Corus CAD features include the fact that the test works equally well in both men and women.

Herman’s wish list for the Corus CAD test pertains to reimbursement. “While I was pleased to see the recent announcement that Aetna is now covering Corus CAD (along with Medicare),” says Herman, “it would be nice to see broader insurance reimbursement as it is a fantastic tool for primary care and even cardiologists. The cost-effective tool can also lower health care costs, which is important in this environment.”

Objective Medical Systems (OMS) Cardiovascular Diagnostics Suite

Learn more at objectivemedicalsystems.com or email contactus@omscardio.com.

Objective Medical Systems

The Objective Medical Systems (OMS) cardiovascular diagnostics suite offers 16 modules including invasive and non-invasive diagnostics tests. Practicing cardiologists designed the cardiovascular diagnostics suite from the ground up with cardiologists in mind. In fact, one of the company’s own cardiologists coded much of the software himself, says CEO Colby LeMaire. The OMS cardiovascular diagnostics suite interfaces directly with the OMS EHR, giving cardiologists a 360-degree view of the patient.

According to LeMaire, the cardiovascular diagnostics suite interfaces directly with medical devices, seamlessly analyzing thousands of discrete data elements in the background. This provides the physician with actionable intelligence at the point of care, all the while eliminating dictation, transcription and free-text typing. “This provides state-of-the-art reporting for echo, vascular US, holter and nuclear perfusion among others,” says LeMaire.

Bart Denys, M.D., medical director and interventional cardiologist at Cardiovascular Institute of the South in Thibodaux, Louisiana, serves patients in a single-specialty cardiology group covering a large territory in Louisiana with 15 locations. With an average of 225,000 patient encounters per year, the practice’s primary concern is the high volume of patient visits per physician, says Denys. The practice employs 60 physicians in all.

Cardiovascular Diagnostics Suite

The cardiovascular diagnostics suite from Objective Medical Systems enables physicians to conveniently create reports, review studies and more.

When Denys discovered the OMS system, he was looking for a next-generation electronic medical record system that would facilitate the high volume practice, interact with hospital and state-based systems, and work with national professional databases, such as the interventional national database, as well as address many other practice needs. Denys decided on OMS and today uses the OMS EHR version 1.0 and the OMS Diagnostic Module version 1.2 to meet all these needs.

The new system helps his patients immensely. Denys says that whenever all pertinent information is readily available and a system alerts physicians to abnormalities, possible side effects, interactions and recommendations, physicians are less likely to miss things and more likely to address issues to a currently accepted standard of care. “The dynamic aspect of all this data helps our physicians with continuity of care,” he says. “Our patients can walk into any of our clinics over a large geographical area and find that the same information plan and recommendations are available to each of our physicians. Additionally, the availability of this data over a virtual private network from outside our practice allows our physicians and nurse practitioners to access all patient information 24/7 for hospitalized patients or emergency room admissions.”

Instant availability of information, trending information and help with the appropriateness of E&M codes are his favorite features of the system. “Unlike general hospital systems, where one has to wade through pages and pages of information, this system does what an electronic medical record is supposed to do: It gets the information, it presents it, it compares it, and it uses the information to actively suggest how we can improve patient care,” Denys says.

His wish list for future OMS system features includes an integrated OMS module linking cath lab data, angiographically and hemodynamically, to inventory, cost and billing.

David Geer is a frequent contributor to PracticeLink Magazine’s Tech Notes department.

 

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