Healthcare IT - Intelligent Ways to Support Patient Treatment · Copyright © Siemens AG 2012. All...

Copyright © Siemens AG 2012. All rights reserved.

Dr. Arthur Kaindl

Healthcare IT - Intelligent Ways to

Support Patient Treatment June 22, 2012

Dr. Arthur Kaindl


Page 1 Dr. Arthur Kaindl


Dr. Arthur Kaindl

Medical History

Aortic valve stenosis

79 y/o patient with degenerate aortic valve

Symptoms

Apoplectic insult three years ago

Chronic kidney disease:

eGFR of 35 – 40 ml/min

Blood pressure: 150/100 mmHg

Chronic obstructive lung disease

Diabetes mellitus (type 2)

For 2 weeks: Shortness of breath and

chest pain after exertion

Now patient faints after exertion

Hospital IT Diagnostics IT Imaging IT

Page 2


Dr. Arthur Kaindl

Auscultation: Heart murmur due to the

reduced orifice of the diseased and

calcified aortic valve

ECG: No ST segment elevation but

indication for left ventricular

hypertrophy

Blood test to analyze heart enzymes –

Troponin negative

Emergency diagnosis and treatment

Symptoms suggest aortic valve stenosis


Page 3


Dr. Arthur Kaindl

AVA: Aortic valve area

Emergency diagnosis and treatment

Symptoms suggest aortic valve stenosis


Trans-thoracic echo

Jet velocity 5 m/s

AVA 0.7 cm2

Mean transvalvular pressure gradient

55 mmHg

Calcifications of aortic valve

Page 4


Dr. Arthur Kaindl

Aortic valve replacement

Severe co-morbities indicate the TAVI procedure

TAVI: Trans-catheter aortic valve implantation


Aortic valve stenosis due to

degeneration and calcification of aortic

valve

Increased risk of mortality for aortic

valve surgery due to severe

co-morbidities

Minimally invasive TAVI procedure is

method of choice

Page 5


Dr. Arthur Kaindl


Tube voltage 120/120 kV

Scan length 587 mm

Scan time 1.37 s

Radiation dose 4.3 mSv

Courtesy S. Gauß, University of Erlangen-Nuremberg, Erlangen, Germany * W. Wuest et al., Eur. Radiol., August 2011

SOMATOM Definition Flash

Safer procedures through less contrast agent

Contrast agent dose:

40 mL *

Page 6


Dr. Arthur Kaindl Author

syngo.via cardio vascular diagnostics

Efficiency … via automated case preparation

Preferred layout applied

Automated CPR of the main coronaries

Automated bone and blood pool removal

Author Page 7 Dr. Arthur Kaindl


Dr. Arthur Kaindl


(1) Selecting of application

(2) Pre-selection of preliminary exams

(3) Selection of best cardiac phase

(4) Removal of ribs from chest CT

(5) Removal of bony structure

(7) Reconstruction of MPR and VRT

(8) Extraction of luminal centerlines

(6) Removing of blood-pool

The conventional process for Case Preparation

First Vessel prepared for reading 8 manual steps

syngo.via

First Vessel prepared for reading

syngo.via cardio vascular diagnostic

Intelligent processing with syngo.via

The displayed feature is a syngo.via-based software option which is a medical device on its own right.

Page 8


Dr. Arthur Kaindl

syngo.via* CT Tavi Planning

Intelligent display for accurate measurements

Find the smallest iliac diameter with a single click

Visualize and remove aortic calcifications

based on single energy data


* CT Tavi planning is performed with syngo.CT Vascular Analysis, which is a medical device in its

own right.


Dr. Arthur Kaindl



Quantify the area, short and long axes of the aortic annulus

Measure the distance to the coronary ostia



Dr. Arthur Kaindl



All results are documented in a report

Angulation of the C-arm is displayed



Dr. Arthur Kaindl

Surgery in the cath lab


Page 12


Dr. Arthur Kaindl

Successful treatment

Aortic valve stenosis treated

Heart function restored

Patient will be sent to rehab

Will need regular check up with

cardiologist

Page 13


Dr. Arthur Kaindl

Vision becomes reality

Integration of information

Siemens Healthcare IT

incorporates the information from

all aspects of care and assimilates

the data for ease of use




Dr. Arthur Kaindl

to day!

thing is Every

Apple®, the iPhone™, the iPad™, iPod Touch™ are trademarks of Apple Inc., registered in the aU.S. and other countries.


mobile


Dr. Arthur Kaindl

syngo.via WebViewer and WebReport App

For iPhone and iPad country specific laws may apply. Please refer to these laws before using

for diagnostic reading/viewing. The syngo.via Web solutions are not for diagnostic use with

mobile devices, such as iPhone or iPad. Diagnostic use requires a medical grade monitor.




Dr. Arthur Kaindl

Future concepts

Cloud services and applications

Big-Data Managment

Data Analytics

Ap

pli

cati

on

Hu

b

Self Service Portal

Transactional

Services

Clinical

Applications

Provider Business

Applications

Payor Business

Applications

Research/Teaching

Applications

Patient

Applications

Administrator

Applications

Next-Gen App Environment

(e.g. V-PaaS)

Legacy App Environment

(e.g. Vmware IaaS)

• Manage subscriptions

• On-line tutorials

• Application support

• Billing

• 3rd party application mngt

• User2User transactions

• Personal Mobile Apps (e.g. MyPatients)

• Virtual Conferencing

• „3D anywhere“ services

• BI for departmental efficiency

• Benchmarking Services

• Referral Analysis / Case Analysis

• Treatment Path Analysis

• Longitudinal Patient analysis

• Procedure trending

• Reference Case Library

• Cohort Identification

• Collaboration / Education

• Share Clinical Results

• 2nd Opinion Services

• Life-Style indicator analysis

• System health trending

• Technical Documentation

• On-line Training & Support

Medical Archiving / VNA

IHE Components

incl. 3rd party applications

Arc

hiv

ing

/ D

isaste

r R

eco

very

Serv

ices

Cro

ss-D

ep

art

men

tal In

teg

rati

on

Cro

ss-E

nte

rpri

se In

teg

rati

on

Fe

atu

re e

xte

ns

ion

s

Applications

Page 17


Dr. Arthur Kaindl Date Autho

syngo. It’s all about you.

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