Norton Healthcare is Kentucky’s largest healthcare system with more than 40 locations in and around Louisville, Kentucky and over 1950 beds. When compared to other healthcare providers in Louisville, Kentucky, Norton is the market share leader in five major service areas. This includes 46% of all inpatient admissions, 61% of all births, 53% of all emergency department visits, 41% of all outpatient visits, and 50% of total surgeries.
The system’s most notable locations are five acute care hospitals located within Metro Louisville:
- Kosair Children’s Hospital (263 licensed beds) – Kentucky’s only free-standing full-service children’s hospital
- Norton Audubon Hospital (480 licensed beds)
- Norton Hospital & Norton Healthcare Pavilion (719 licensed beds)
- Norton Suburban Hospital (380 licensed beds)
- Norton Brownsboro Hospital (127 licensed beds)
Additionally, Norton Healthcare provides service through twelve immediate care centers in the Louisville area.
Coffey Medical: Thank you for taking time to speak with me today about what you have accomplished in your department with regards to standardizing of diagnostic testing. What were you trying to accomplish when you made the decision to use Philips Zymed Holter Software instead of the Spacelabs Holter solution you had been using at some of your locations?
Steve: The deciding factor for us to use Philips Zymed was that we wanted to utilize our Tracemaster Vue ECG Management system more, while also having a standard software that we could better use across all Norton Healthcare locations, so that doctors could order and view Holter studies from anywhere.
Coffey: Were there any clinical issues that made you choose Zymed?
Steve: I had worked with Zymed before and liked the system. I felt the clarity of the ECG coming off the system was better using the EASI hook-up. The lightweight recorders were a plus for the patients as well.
Coffey: That ended up being quite a few locations, didn’t it?
Steve: Besides the 5 hospitals, we have 30 telemedicine sites at which physicians can order Holter studies, and patients can go home with a Holter recorder.
Coffey: How many Holter studies are you doing currently on a monthly basis?
Steve: We are doing over 500 holter studies a month.
Coffey: Have you been able to capture any numbers on what you have gained by standardizing your system on Zymed Holter software?
Steve: We have added hospitals and clinics around Louisville and in southern Indiana that are now using our Zymed Holter services to offer patient testing–they aren’t part of Norton Healthcare, but do refer patients to us.
Coffey: How do you offer that service to these other hospitals? Why are they taking you up on this offer?
Steve: Primarily, some of our cardiologists cover smaller hospitals and clinics (who don’t have a cardiologist on staff) that might be 30 miles or more away from a Norton Hospital.
Coffey: How do you handle billing in this situation?
Steve: The telemedicine hospital site or clinic bills the technical and hook-up fee, while the reading cardiologist bills the professional component. Then, Norton charges a fee to the participating hospital for doing the actual Holter scanning and report generation.
Coffey: How do your doctors make the decision to order a Holter study? Do you have any standards of care of when a Holter study should be ordered with your employee physicians?
Steve: It is up to the physicians to look at the results of previous testing and determine if ordering a Holter study is appropriate. At our telemedicine sites where no cardiologist is on staff, they can put a Holter recorder on a patient, and then send us the data for scanning. Our cardiologists then assess the Holter Report and determine if the patient needs to come in for further testing and treatment.
Coffey: How has offering Holter services to telemedicine sites benefited your physicians and their patients?
Steve: Several of our physicians serve these clinics, and they are able to share results from their Holter testing with their patients more easily on follow-up visits. I am sure we have had patients receive pacemakers as a result of us offering Holter services at these sites. The clinics are able to offer the test without having the acquisition cost of a Holter system.
Coffey: How are you handling the workflow for these satellite sites?
Steve: We receive the Holter data remotely from the satellite site using the Zymed Remote Link. After scanning the study and creating the Holter report, we send the final report back to the satellite location using Zymed Remote Link, and provide a copy to the reading physician. The reading physician then signs into the facility’s transcription department and dictates the report.
Coffey: How do you get the reports into the patient’s medical record?
Steve: We are in the process from switching from Meditech to Epic. Currently, we are scanning the final Holter reports into Meditech.
Coffey: How do you get the doctor’s report of findings into the patient’s chart?
Steve: There is an accession number that they look at. So anything scanned in is attached to that accession number.
Coffey: Do you see any changes you are going to make to this process in the future?
Steve: After the hospital completes the switch over from Meditech to Epic, we are going to focus on streamlining the process by hosting Holter reports online for the physicians to read, edit and confirm electronically, all linked to the patient’s digital chart.
Coffey: Thank you, Steve, for your time.